论文部分内容阅读
目的明确M65和M30对慢性乙型肝炎患者肝脏炎症程度的诊断价值。方法共纳入186例未经治疗的慢性乙型肝炎患者,病理学肝脏炎症程度分为G1至G4级,肝脏纤维化程度分为S1至S4期,并在肝穿前后1周时间内采血;选择性别和年龄匹配的18例正常人作为健康对照,进行血清M65、M30检测。结果血清M65和M30水平与转氨酶有一定相关性,随着肝脏炎症程度的加重而升高,G2和cG3组的M65中位水平分别为208.3和238.8 U/L,M30中位水平为251.8和282.9 U/L,二者水平均显著高于正常人(M65:144.5 U/L;M30:208.8 U/L)和G1组(M65:199.6 U/L,M30:241.9 U/L)。多因素分析表明血清M65水平是严重肝脏炎症的独立预测指标。在S1患者中,血清M65和M30水平均随着肝脏炎症程度的加重而升高,炎症损伤较重的G2S1组的血清M65和M30中位水平为206.0U/L、280.7 U/L,均高于G1S1组(M65:190.5 U/L,M30:241.9 U/L)。结论慢性乙型肝炎患者血清M65水平与肝组织炎症程度相关,具有一定的辅助诊断价值,其临床应用价值优于M30。
Objective To determine the diagnostic value of M65 and M30 in the degree of liver inflammation in patients with chronic hepatitis B. METHODS: A total of 186 patients with untreated chronic hepatitis B were enrolled. Pathological liver inflammation was classified as G1 to G4, liver fibrosis was divided into S1 to S4, and blood was collected within 1 week before and after liver transplantation. Eighteen healthy people, matched by age and sex, were taken as healthy controls and serum M65, M30 were detected. Results Serum levels of M65 and M30 were correlated with aminotransferase and increased with the severity of liver inflammation. The median levels of M65 in G2 and cG3 were 208.3 and 238.8 U / L, respectively. The median M30 levels were 251.8 and 282.9 U / L, both of which were significantly higher than those in normal subjects (M65: 144.5 U / L; M30: 208.8 U / L) and G1 (M65: 199.6 U / L, M30: 241.9 U / L). Multivariate analysis showed that serum M65 level was an independent predictor of severe liver inflammation. In patients with S1, the levels of serum M65 and M30 increased with the severity of liver inflammation, and the median levels of serum M65 and M30 in G2S1 group with severe inflammation were 206.0U / L and 280.7U / L, respectively Group G1S1 (M65: 190.5 U / L, M30: 241.9 U / L). Conclusions Serum M65 level in patients with chronic hepatitis B is related to the degree of liver inflammation and has some auxiliary diagnostic value. The clinical value of M65 is better than that of M30.