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目的:探讨血清细胞角蛋白-18裂解片段M30(CK-18 M30)和基质金属蛋白酶(MMP-2)水平对乙型肝炎e抗原(HBe Ag)阴性慢性乙型肝炎纤维化严重程度预测的作用。方法:选取我院156例HBe Ag阴性的慢性乙型肝炎(CHB)患者和51例对照组。肝组织病理学分级依据Scheuer标准。常规收集临床资料,ELISA法检测血清CK-18 M30和MMP-2水平。结果:本研究CHB组男性为106人(67.9%),女性为50人(32.1%);对照组男性为33人(63.5%),女性为19人(36.5%),两组间性别、年龄无统计学差异;CHB组CK-18 M30和MMP-2显著高于对照组(P<0.001)。CK-18 M30预测是否有显著性肝纤维化的AUC为0.863(P<0.001);而MMP-2预测是否有显著性肝纤维化的AUC为0.587,差异无统计学意义(P=0.064)。结论:血清CK-18 M30和MMP-2水平在CHB组显著升高,CK-18 M30可能可预测HBe Ag阴性的慢性乙型肝炎纤维化严重程度,可能具有较好的临床应用前景。
Objective: To investigate the effects of serum CK-18 M30 and MMP-2 on the prediction of severity of fibrosis in patients with chronic hepatitis B due to hepatitis B e antigen (HBeAg) -negative chronic hepatitis B . Methods: 156 HBeAg-negative chronic hepatitis B (CHB) patients and 51 control subjects were selected in our hospital. Histopathological grading was based on the Scheuer criteria. The clinical data were collected routinely. The levels of serum CK-18 M30 and MMP-2 were detected by ELISA. Results: In this study, there were 106 males (67.9%) and 50 females (32.1%) in the CHB group, 33 males (63.5%) and 19 females (36.5%) in the control group. The gender, age There was no significant difference between the two groups. CK-18 M30 and MMP-2 in CHB group were significantly higher than those in control group (P <0.001). The AUC of CK-18 M30 in predicting whether there was significant hepatic fibrosis was 0.863 (P <0.001), while the AUC of MMP-2 in predicting whether there was significant hepatic fibrosis was 0.587, the difference was not statistically significant (P = 0.064). CONCLUSION: Serum CK-18 M30 and MMP-2 levels are significantly elevated in CHB group. CK-18 M30 may predict the severity of HBeAg-negative chronic hepatitis B fibrosis and may have a good clinical application prospect.