乙型肝炎合并肝硬化患者血清 GP73变化特征及临床意义

摘要

Objective To explore clinical profile and significance of serum golgi protein 73 (GP73) in cirrhotic patients with chronic hepatitis B virus (HBV) infection .Methods A total of 109 cirrhotic patients with HBV infection were included ,in which 60 patients were compensated cirrhosis ,and 49 patients were decompensated cirrhosis .The receiver operating characteristic curve (ROC) analysis were used to evaluate the clinical significance of GP73 for diagnosing decompensated cirrhosis in cirrhotic popula-tion .Results Serum GP73 level in cirrhotic patients was correlated with alanine aminotransferase (ALT ) and HBV DNA ,but neg-atively correlated with albumin levels .Serum GP73 levels in patients with decompensated cirrhosis was (215 .9 ± 96 .56)ng/mL , which was significant higher than (113 .7 ± 68 .95)ng/mL in patients with compensated cirrhosis .The area under ROC was 0 .82 (95% CI :0 .74 ~ 0 .90 ,P< 0 .05) .The sensitivity and specificity of GP73 diagnosing decompensated cirrhosis in cirrhotic population with chronic HBV infection were 77 .55% and 75 .00% respectively ,when the cut-off was set at 140 .5 ng/mL .Conclusion Serum GP73 level is related with liver injury and HBV replication .GP73 might be an useful marker for diagnosing decompensated cirrhosis in cirrhotic population with chronic HBV infections .%目的：明确慢乙型肝炎患者血清 GP73变化特征及可能的临床意义。方法观察了109例慢乙型肝炎肝硬化患者血清 GP73水平及可能的相关因素，其中代偿期肝硬化患者60例，失代偿肝硬化患者49例。对血清 GP73鉴别代偿性及失代偿性肝硬化的诊断性能进行了受试者工作特征曲线（ROC）分析。结果慢乙型肝炎肝硬化患者血清 GP73与血清丙氨酸氨基转移酶（ALT ）、乙型肝炎病毒拷贝数（HBV DNA ）水平显著相关，但与患者血清清蛋白水平呈显著负相关。失代偿性肝硬化患者[（215．9±96．56）ng ／mL]血清 GP73水平显著高于代偿期肝硬化患者[（113．7±68．95）ng／mL ]。 ROC 分析结果显示，曲线下面积为0．82（95％ CI ：0．74～0．90，P ＜0．05）。当 cut-off 值设定为大于或等于140．5 ng ／mL 时，在乙型肝炎肝硬化患者人群中， GP73诊断失代偿期肝硬化的灵敏度和特异度分别为77．55％和75．00％。结论慢性乙型肝炎合并肝硬化患者血清 GP73水平与肝损伤及病毒复制状态有关。检测血清 GP73有助于肝硬化代偿与失代偿期之间的鉴别。