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非酒精性脂肪性肝炎患者中晚期氧化蛋白产物(AOPP)与生化及组织病理学发现的关系。

The relationship between advanced oxidation protein products (AOPP) and biochemical and histopathological findings in patients with nonalcoholic steatohepatitis.

机构信息

Department of Gastroenterology, Faculty of Medicine, Gazi University Hospital, Ankara, Turkey.

出版信息

J Dig Dis. 2014 Mar;15(3):131-6. doi: 10.1111/1751-2980.12113.

Abstract

OBJECTIVE

To investigate the correlation between advanced oxidation protein products (AOPP) levels and biochemical and histopathological findings in patients with nonalcoholic steatohepatitis (NASH).

METHODS

Sixty biopsy-proven NASH patients and 60 individuals with ultrasonographically healthy liver (the control group) were included in the study. AOPP levels were determined in all the participants and liver histopathological examination based on liver biopsy was performed in NASH patients. The NASH activity score (NAS), hepatosteatosis, liver inflammation and fibrosis were evaluated.

RESULTS

Serum AOPP level was significantly higher in the NASH group than that in the control group (461.8 ± 201.9 μmol/L vs 191.7 ± 152.5 μmol/L, P < 0.001). The receiver operating characteristic (ROC) curve revealed a sensitivity of 73.3% and a specificity of 88.3% for the diagnosis of NASH with an AOPP cut-off value of 332 μmol/L (the area under ROC curve 0.88, 95% confidence interval 0.82-0.94, P < 0.01). AOPP levels were positively correlated with NAS (r = 0.27, P = 0.035), fibrosis (r = 0.27, P = 0.037) and inflammation (r = 0.34, P = 0.008), but not the grade of steatosis (r = 0.02, P = 0.83) or ballooning (r = 0.02, P = 0.55).

CONCLUSIONS

AOPP levels are significantly higher in patients with NASH than in those with ultrasonographically healthy liver. AOPP levels are positively correlated with biochemical and histopathological findings (NAS, liver inflammation and fibrosis), indicating that AOPP may play a role in the development of liver fibrosis and inflammation and may predict liver histopathology in NASH.

摘要

目的

研究非酒精性脂肪性肝炎(NASH)患者血清中晚期氧化蛋白产物(AOPP)水平与生化和组织病理学的相关性。

方法

本研究共纳入 60 例经肝活检证实的 NASH 患者和 60 例超声检查肝脏正常的个体(对照组)。所有参与者均测定 AOPP 水平,NASH 患者行肝活检进行肝组织病理学检查。评估 NASH 活动评分(NAS)、肝脂肪变性、肝炎症和纤维化。

结果

NASH 组血清 AOPP 水平明显高于对照组(461.8±201.9 μmol/L 比 191.7±152.5 μmol/L,P<0.001)。受试者工作特征(ROC)曲线显示,AOPP 截断值为 332 μmol/L 时,对 NASH 的诊断敏感性为 73.3%,特异性为 88.3%(ROC 曲线下面积 0.88,95%置信区间 0.82-0.94,P<0.01)。AOPP 水平与 NAS(r=0.27,P=0.035)、纤维化(r=0.27,P=0.037)和炎症(r=0.34,P=0.008)呈正相关,但与脂肪变性程度(r=0.02,P=0.83)或气球样变(r=0.02,P=0.55)无关。

结论

NASH 患者血清 AOPP 水平明显高于超声检查肝脏正常者。AOPP 水平与生化和组织病理学发现(NAS、肝炎症和纤维化)呈正相关,表明 AOPP 可能在肝纤维化和炎症的发生中起作用,并可预测 NASH 的肝组织病理学变化。

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