自身免疫性肝病患者血清GP73变化特征

摘要

Objective To evaluate the serum levels of GP73 for diagnosing autoimmune liver disease.Methods Three populations were included:80 patients with autoimmune liver disease; 80 patients with chronic hepatitis B,and 80 apparently healthy controls.Results The serum levels of GP73 in patients with autoimmune liver disease (112.3 ± 72.55 ng/ml) were significantly higher than those of patients with chronic hepatitis B (86.44 ± 60.69 ng/ml),and healthy controls (35.84 ± 11.8 ng/ml).However,there were no significant differences was observed in group of subjects with autoimmune hepatitis (107.4 ± 90.6 ng/ml),primary biliary cirrhosis ((89.0 ± 45.38 ng/ml),and primary sclerosing cholangitis (113.3 ± 50.87 ng/ml).Chosen the healthy control as "control group",the patients with chronic hepatitis B as "patients group ",the sensitivity and specificity of GP73 for diagnosing autoimmune liver disease were 75.0％ and 97.53％,respectively.The area of ROC analysis was 0.93(95％ CI;0.89-0.97).Conclusion The serum GP73 levels was significantly increased in patients with autoimmune liver disease,compared with those of healthy controls.For patients with higher levels of serum GP73,diagnosis of autoimmune liver disease should also be considered,especially for those patients with overlap-syndrome,except for chronic virus hepatitis and hepatocellular carcinoma.%目的 明确自身免疫性肝病患者血清GP73的水平特征及可能的临床意义.方法 本研究共观察了健康体检、慢性乙型肝炎患者,以及自身免疫性肝病患者各80例的血清GP73水平.结果 与健康对照人群的血清GP73水平(35.84±11.8) ng/ml相比,自身免疫性肝病患者(112.3±72.55) ng/ml显著升高,也显著高于慢性乙型肝炎患者(86.44±60.69) ng/ml.但自身免疫性肝炎(107.4±90.6)ng/ml,原发性胆汁淤积性肝硬化(89.0±45.38) ng/ml,以及原发性硬化性胆管炎(113.3±50.87) ng/ml患者之间并无显著性差异,但均低于重叠综合症的患者(153.3±86.89ng/ml).以健康体检人群为参照人群,以61.35 ng/ml为cut-off值,GP73诊断自身免疫性肝病的特异性和敏感性分别为75.0％和97.53％.ROC分析曲线下面积为为0.93(95％ CI:0.89-0.97).结论 自身免疫性肝病患者血清GP73显著高于健康对照人群,尤其是那些重叠综合征的患者.对于GP73升高的患者,除考虑病毒性肝炎,肝癌外,也应该考虑自身性免疫性肝病的可能.