C-C趋化因子配体5对代谢相关脂肪性肝纤维化的诊断价值

Diagnostic value of C-C chemokine ligand 5 for liver fibrosis in metabolic-associated fatty liver disease

目的探究血清C-C趋化因子配体5(CCL5)评估代谢相关脂肪性肝病(MAFLD)患者肝纤维化程度的诊断价值。方法诊断性试验。选择2021年10月至2023年6月就诊于河北医科大学第三医院中西医结合肝病科行肝穿刺活组织病理学检查的MAFLD患者71例,同期该院体检中心71例健康体检者为对照组,采用酶联免疫吸附法检测血清CCL5水平;常规检测血常规及肝肾功能等,分析CCL5的表达水平及其与上述指标的相关性,计算天冬氨酸转氨酶/血小板比值指数(APRI)、基于4因子的纤维化指数(FIB-4)。采用SPSS 26.0软件进行统计学分析,应用受试者操作特征曲线下面积(AUC)评估CCL5对MAFLD纤维化程度的诊断效能,并进一步分析其与APRI及FIB-4联合诊断MAFLD纤维化程度的效能。结果在MAFLD患者中,血清CCL5的表达水平随着肝纤维化分期的升高,其水平逐渐升高,且差异有统计学意义(P<0.05)。血清CCL5诊断MAFLD患者显著肝纤维化的AUC值为0.775,敏感度为65.7%,特异度为80.6%,最佳截断值为49.845 ng/ml;CCL5与FIB-4联合应用时,对MAFLD患者显著肝纤维化的诊断价值最高,AUC为0.802,敏感度为91.4%,特异度为61.1%。结论CCL5对MAFLD患者显著肝纤维化有较高的诊断价值,有望成为评估MAFLD患者肝纤维化程度的无创诊断标志物。

ObjectiveTo explore the diagnostic value of serum C-C chemokine ligand 5(CCL5)in assessing the degree of liver fibrosis in patients with metabolic-associated fatty liver disease(MAFLD).Methods71 MAFLD patients who visited the Department of Integrated Traditional and Western Medical Hepatology,Third Hospital of Hebei Medical University,and underwent liver biopsy histopathology examinations between October 2021 and June 2023 were selected for diagnostic testing.Simultaneously,71 healthy subjects who underwent physical examinations at the physical examination center of the hospital were selected as the control group.Serum CCL5 levels were detected using an enzyme-linked immunosorbent assay(ELISA).Routine blood tests,liver and kidney function tests,and other tests were conducted to analyze the expression level of CCL5 and its correlation with the above indicators.The aspartate aminotransferase/platelet ratio index(APRI)and fibrosis 4 index(FIB-4)were calculated.SPSS 26.0 software was used for statistical analysis.The area under the receiver operating characteristic curve(ROC)was used to evaluate the diagnostic efficacy of CCL5 for the degree of liver fibrosis in MAFLD.The combined diagnostic efficacy of APRI and FIB-4 was further analyzed for the degree of liver fibrosis in MAFLD.ResultsThe expression level of serum CCL5 gradually increased with the increase in liver fibrosis stage in patients with MAFLD,and the difference was statistically significant(P<0.05).The AUC value of serum CCL5 for diagnosing significant liver fibrosis in MAFLD patients was 0.775,with a sensitivity of 65.7%,a specificity of 80.6%,and an optimal cutoff value of 49.845 ng/ml.The CCL5 and FIB-4 combination had the highest diagnostic value for significant liver fibrosis in patients with MAFLD,with an AUC of 0.802,a sensitivity of 91.4%,and a specificity of 61.1%.ConclusionCCL5 has a high diagnostic value for significant liver fibrosis in MAFLD patients.Therefore,it is expected to become a non-invasive diagnostic marker for assessing the degree of liver fibrosis in MAFLD patients.