高尔基体蛋白73在自身免疫性肝病鉴别诊断及疗效评估中的价值

Value of Golgi Protein 73 in the Differential Diagnosis of Autoimmune Liver Disease and Efficacy Evaluation

为了探讨高尔基体蛋白73(GP73)在自身免疫性肝病(AILD)鉴别诊断及疗效评估中的价值,选取2020年1月至2023年的7月在本院就诊的144例病毒性肝炎患者和55例AILD患者[自身免疫性肝炎(AIH)20例、原发性胆汁性胆管炎(PBC)19例及原发性硬化性胆管炎(PSC)16例]为研究对象,分别纳入病毒性肝炎组与AILD组。测定三组受试者GP73水平,并比较不同分型AILD患者GP73水平;AILD患者接受免疫抑制治疗1 w后,检测血清丙氨酸氨基转移酶(ALT)与GP73水平,根据ALT测定结果将AILD患者分成A组[ALT<2倍正常值上限(ULN)]与B组(ALT≥2×ULN),并对A组患者进行肝活检,评估纤维化分期,分析GP73水平与纤维化分期的相关性。结果发现,AILD组和病毒性肝炎组GP73水平均高于对照组(P<0.05),且AILD组和病毒性肝炎组GP73水平比较,差异无统计学意义(P>0.05);不同分型AILD患者GP73水平比较,差异无统计学意义(P>0.05);B组GP73水平高于A组(P<0.05),且A组纤维化分期≥S2期的患者为35.09%(20/57);A组患者GP73水平与纤维化分期呈正相关(r=0.384,P<0.05)。GP73无法有效鉴别AILD与病毒性肝炎,以及区分AILD类型,但可以辅助诊断AILD,且可以用于ALT<2×ULN的AILD患者疗效评估。

The aim of this study was to explore the value of Golgi protein 73(GP73)in the differential diagnosis of autoimmune liver disease(AILD)and efficacy evaluation.In the study,144 patients with viral hepatitis and 55 patients with AILD[20 cases with autoimmune hepatitis(AIH),19 cases with primary biliary cholangitis(PBC),16 cases with primary sclerosing cholangitis(PSC)]in the hospital were enrolled as viral hepatitis group and AILD group between January 2020 and July 2023,respectively.GP73 level in the three groups was detected,and which in patients with different classifications of AILD was compared.After 1 week of immunosuppressive therapy,levels of serum alanine aminotransferase(ALT)and GP73 were detected.According to ALT,AILD patients were divided into group A[ALT<2 upper limit of normal(ULN)]and group B(ALT≥2×ULN).The liver biopsy was performed in group A to evaluate fibrosis staging.The correlation between GP73 level and fibrosis staging was analyzed.The study results showed that GP73 level in AILD group and viral hepatitis group was higher than that in control group(P<0.05),but there was no significant difference between AILD group and viral hepatitis group(P>0.05).There was no significant difference in GP73 level among patients with different classifications of AILD(P>0.05).GP73 level in group B was higher than that in group A(P<0.05).The proportion of cases with fibrosis staging≥S2 was 35.09%(20/57)in group A.In group A,there was a positive correlation between GP73 level and fibrosis staging(r=0.384,P<0.05).It can be concluded that GP73 is not effective in the differential diagnosis of AILD and viral hepatitis or distinguishing AILD classifications.However,it can assist in the diagnosis of AILD and can be applied in efficacy evaluation for AILD patients with ALT<2×ULN.