【摘 要】
：
目的 寻找无创性诊断非酒精性脂肪性肝炎(NASH)的生物指标已成为世界性探究热点课题.验证组合细胞角蛋白18-M30片段(CK-18-M30)、成纤维细胞生长因子21(FGF-21)、IL-1受体拮抗剂(IL-1Ra)、色素上皮细胞衍生因子(PEDF)和骨保护素(OPG)诊断非酒精性脂肪性肝病(NAFLD)和NASH的效能.方法 前瞻性选取配套肝穿刺活组织病理学检查的242例NAFLD患者,随机分
【机 构】
：
100039 北京,中国人民解放军第三〇二医院病理诊断与研究中心 100039 北京,中国人民解放
【出 处】
：
The 14th Congress of Gastroenterology China(第十四届全国消化系病学术会议)
论文部分内容阅读
目的 寻找无创性诊断非酒精性脂肪性肝炎(NASH)的生物指标已成为世界性探究热点课题.验证组合细胞角蛋白18-M30片段(CK-18-M30)、成纤维细胞生长因子21(FGF-21)、IL-1受体拮抗剂(IL-1Ra)、色素上皮细胞衍生因子(PEDF)和骨保护素(OPG)诊断非酒精性脂肪性肝病(NAFLD)和NASH的效能.方法 前瞻性选取配套肝穿刺活组织病理学检查的242例NAFLD患者,随机分为NAFLD建模组(179例)和验证组(63例)；选取91名性别、年龄均匹配的健康者作为对照组.采用ELISA检测生物指标.结果 NASH组的CK-18-M30、FGF-21、IL-1Ra和PEDF水平最高,其次为非NASH-NAFLD组,健康对照组最低,3组间差异有统计学意义(P＜0.01)；血清OPG水平则相反,3组间差异有统计学意义(P＜0.01).采用ROC曲线诊断NASH时,CK-18-M30曲线下面积(AUROC)为0.86,FGF-21、IL-1Ra、PEDF和OPG均为0.89.采用CK-18-M30对NASH进行诊断,其阴性率(NPV)为70％,阳性率(0PV)为79％.在CK-18-M30基础上应用FGF-21、IL-1Ra、PEDF和OPG依次对NASH进行组合分步诊断,NPV提高至76％,PPV为85％.验证组中应用组合生物指标诊断NASH,NPV和PPV分别为80％和76％.结论 与单个指标诊断NASH相比,CK-18-M30、FGF-21、IL-1Ra、PEDF和OPG组合分步诊断NASH能够极大提高诊断的效能.
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