肝硬化相关血清学指标与Child-Pugh分级的关系

Correlation between serological markers for liver cirrhosis and Child-Pugh class

摘要:

目的：探究肝硬化相关血清学指标与肝硬化Child-Pugh分级之间的关系和临床意义。方法：收集重庆医科大学附属第二医院感染科2016年7月至2017年4月间肝硬化患者血清235例，其中Child-Pugh A组55例，B组90例，C组90例，以及同期健康体检人群35例，分别检测肝功能、肝纤维化、血小板计数等指标并分析其特征。结果：透明质酸（hyaluronic acid，HA）、层粘连蛋白（laminin，LN）、Ⅲ型胶原蛋白（type Ⅲ collagen，PC-Ⅲ）、Ⅳ型胶原蛋白（type Ⅳ collagen，Ⅳ-C）、天门冬氨酸氨基转移酶（aspartate aminotransferase，AST）、丙氨酰氨基转移酶（alanyl aminotransferase，ALT）及天门冬氨酸氨基转移酶与血小板计数比（aspartate aminotransferase to platelet ratio index，APRI）指数之间差异均具有统计学意义（P<0.05）。HA、PC-Ⅲ、Ⅳ-C、LN和AST指标对预测肝硬化的曲线下面积（AUC）分别为0.910、0.804、0.833、0.753、0.730。HA、PC-Ⅲ、Ⅳ-C与Child-Pugh分级呈高度正相关（r>0.7，P<0.01），APRI与分级呈显著性正相关（0.4

Abstract:

Objective：To investigate the correlation between serological markers for liver cirrhosis and Child-Pugh class and its clini－cal significance. Methods：A total of 235 patients with liver cirrhosis who were treated in Department of Infectious Diseases in The Second Affiliated Hospital of Chongqing Medical University from July 2016 to April 2017 were enrolled，among whom 55 had Child-Pugh class A cirrhosis，90 had Child-Pugh class B cirrhosis，and 90 had Child-Pugh class C cirrhosis，and 35 individuals who under－went physical examination during the same period of time were enrolled as controls. The indices including liver function parameters，liver fibrosis indices，and platelet count were measured and analyzed. Results：There were significant differences between the two groups in hyaluronic acid（HA），laminin（LN），type Ⅲ collagen（PC-Ⅲ），type Ⅳ collagen（Ⅳ-C），aspartate aminotransferase（AST），alanine aminotransferase（ALT），and aspartate aminotransferase-to-platelet ratio index（APRI）（P<0.05）. HA，PC-Ⅲ，Ⅳ-C，LN，and AST had an area under the ROC curve of 0.910，0.804，0.833，0.753，and 0.730，respectively. HA，PC-Ⅲ，and Ⅳ-C were positively correlated with Child-Pugh class（r>0.7，P<0.01），and APRI was positively correlated with Child-Pugh score（0.4