超声弹性成像联合血清Mac-2结合蛋白糖基化异构体、NADPH氧化酶2对慢性乙型肝炎患者肝纤维化的诊断价值
Diagnostic value of ultrasound elastography combined with serum Mac-2 binding protein glycosylation isomer and NADPH oxidase 2 for hepatic fibrosis in patients with chronic hepatitis B
谭雅玲 1汪长青 2吴珍宝 2明全3
作者信息
- 1. 443200,宜昌市第三人民医院(三峡大学第三人民医院)超声室
- 2. 443200,宜昌市第三人民医院(三峡大学第三人民医院)普外科
- 3. 443200,宜昌市第三人民医院(三峡大学第三人民医院)肝病科
- 折叠
摘要
目的 探讨超声弹性成像联合血清Mac-2结合蛋白糖基化异构体(Mac-2 binds protein glycosylated isomers,M2BPGi)、还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶2(NADPH oxidase 2,NOX2)对慢性乙型肝炎(chronic hepatitis B,CHB)患者肝纤维化的诊断价值.为肝纤维化的诊断提供参考依据.方法 选取宜昌市第三人民医院于2021年1月—2023年3月期间收治的175例CHB患者为研究对象,并根据肝纤维化程度分为非显著性肝纤维化组(n=67)和显著性肝纤维化组(n=108).多因素Logistic回归分析法分析发生显著性肝纤维化的影响因素;超声弹性成像联合血清M2BPGi、NOX2水平对显著性肝纤维化的诊断价值采用受试者工作特征(receiver operating characteristic,ROC)曲线分析.结果 非显著性肝纤维化组和显著性肝纤维化组丙氨酸氨基转移酶(alanine transaminase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、白蛋白(albumin,ALB)和血小板计数(platelet count,PLT)比较差异均具有统计学意义(P均<0.05);与非显著性肝纤维化组比较,显著性肝纤维化组患者应变均值(mean strain value,MEAN)和峰度明显较低(P<0.05),偏度、复杂度(complexity,COMP)、对比度、标准差、蓝色区域面积比(ratio of blue area,AREA)和血清M2BPGi和NOX2水平均明显较高(P<0.05).血清M2BPGi、NOX2、ALT、COMP、AREA是影响CHB患者发生显著性肝纤维化的独立危险因素,而PLT和MEAN是其保护因素(P<0.05).ROC分析结果显示,M2BPGi、NOX2、MEAN、COMP和AREA联合诊断显著性肝纤维化的AUC为0.933,显著大于各指标单独诊断的AUC(P<0.05).结论 M2BPGi和NOX2在发生显著性肝纤维化的CHB患者血清中的水平较高,2者联合超声弹性成像对显著性肝纤维化具有较高的诊断价值.
Abstract
Objective To investigate the diagnostic value of ultrasound elastography combined with serum Mac-2 binding protein glycosylation isomer ( M2BPGi ) and reduced nicotinamide adenine dinucleotide phosphate oxidase 2 ( NOX2 ) for liver fibrosis in chronic hepatitis B ( CHB ) patients, to provide a reference basis for the diagnosis of liver fibrosis. Methods A total of 175 patients with CHB admitted to The Third People's Hospital of Yichang City from January 2021 to March 2023 were regarded as the study subjects, and the involved patients were divided into non-significant liver fibrosis group ( n=67 ) and significant liver fibrosis group ( n=108 ) based on the degree of liver fibrosis. Multivariate Logistic regression analysis method was applied to analyze the influencing factors of significant liver fibrosis; Receiver operating characteristic ( ROC ) analysis was applied to analyze the diagnostic value of ultrasound elastography combined with serum levels of M2BPGi and NOX2 for significant liver fibrosis. Results The levels of alanine aminotransferase ( ALT ), aspartate aminotransferase ( AST ), albumin ( ALB ) and platelet count ( PLT ) were significantly different between non-significant hepatic fibrosis group and significant hepatic fibrosis group ( P <0.05 ); compared with the non-significant liver fibrosis group, the MEAN and KURT were obviously lower in the significant liver fibrosis group ( P<0.05 ), while the SKEW, COMP, CONT, SD, AREA, and serum M2BPGi and NOX2 levels were obviously higher ( P <0.05 ); Serum M2BPGi, NOX2, ALT, COMP, and AREA were independent risk factors for significant liver fibrosis in CHB patients, while PLT and MEAN were protective factors ( P < 0.05 ). ROC results showed that the AUC of M2BPGi, NOX2, MEAN, COMP and AREA combined diagnosis of significant hepatic fibrosis was 0.933, which was significantly higher than that of single diagnosis ( P < 0.05 ). Conclusion M2BPGi and NOX2 have higher levels in the serum of CHB patients with significant liver fibrosis, and their combination with ultrasound elastography has high diagnostic value for significant liver fibrosis.
关键词
超声弹性成像/Mac-2结合蛋白糖基化异构体/还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶/慢性乙型肝炎/肝纤维化/诊断价值Key words
ultrasound elastography/Mac-2 binding protein glycosylation isomer/reduced nicotinamide adenine dinucleotide phosphate oxidase 2/chronic hepatitis B/liver fibrosis/diagnostic value引用本文复制引用
出版年
2024
NETL
NSTL
万方数据