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肝硬化和肝癌患者肝纤维化四项指标与肝功能指标的比较

Comparison of four markers of hepatic fibrosis and hepatic function indices in patients with liver cirrhosis and hepatoma.

作者信息

Ma Hong-Yu, Dong Lei, Quan Shou-Zhen, Li Ruo-Yi, Wang Xiang-Rong

机构信息

Clinical Laboratory Department, Air Force Medical Center, PLA, Beijing, China.

Medical Assurance Center, Air Force Medical Center, PLA, Beijing, China.

出版信息

Ann Palliat Med. 2021 Apr;10(4):4108-4121. doi: 10.21037/apm-20-1623. Epub 2021 Mar 24.

Abstract

BACKGROUND

The present study aimed to compare four hepatic fibrosis markers [i.e., hyaluronic acid (HA), laminin (LN), procollagen III N-terminal peptide (PIIINP), and collagen type IV (CIV)] and 16 hepatic function indices in patients with liver cirrhosis of varying etiology.

METHODS

The hepatic function indices and hepatic fibrosis markers were measured in 108 patients with liver cirrhosis and hepatoma using an automatic biochemical analyzer and luminescent immune analyzer. Twenty healthy controls were enrolled to compare the differences between liver cirrhosis and hepatoma of varying etiology and to analyze the correlations between the hepatic function indices and fibrosis markers.

RESULTS

There was no correlation between alanine aminotransferase (ALT), total protein (TP), alkaline phosphatase (ALP), or the four markers of hepatic fibrosis in liver cirrhosis caused by hepatitis B (P>0.05). Aspartate aminotransferase (AST) was positively correlated with HA (r=0.428, P=0.007), LN (r=0.458, P=0.004), and CIV (r=0.374, P=0.021). Total bilirubin (TBIL) and direct bilirubin (DBIL) were positively correlated with LN (TBIL: r=0.480, P=0.002; DBIL: r=0.457, P=0.004), PIIINP (TBIL: r=0.380, P=0.017; DBIL: r=0.406, P=0.011), and CIV (TBIL: r=0.415, P=0.010; DBIL: r=0.400, P=0.013). Total bile acid (TBA) and γ-glutamyltranspeptidase (GGT) were positively correlated with PIIINP (TBA: r=0.363, P=0.025; GGT: r=0.353, P=0.029) and CIV (TBA: r=0.419, P=0.009; GGT: r=0.335, P=0.040). Leucine aminopeptidase (LAP) was positively correlated with LN (r=0.482, P=0.002). Cholinesterase (CHE) (HA: r=-0.452, P=0.004, LN: r=-0.336, P=0.039; PIIINP: r=-0.468, P=0.003; CIV: r=-0.485, P=0.002), prealbumin (PA) (HA: r=-0.575, P=0.000, LN: r=-0.413, P=0.010; PIIINP: r=-0.344, P=0.035; CIV: r=-0.371, P=0.022), albumin (ALB) (HA: r=-0.541, P=0.000, LN: r=-0.373, P=0.021; PIIINP: r=-0.353, P=0.030; CIV: r=-0.415, P=0.010), and superoxide dismutase (SOD) (HA: r=-0.334, P=0.040, LN: r=-0.347, P=0.033; PIIINP: r=-0.487, P=0.002; CIV: r=-0.536, P=0.001) were negatively correlated with the four markers of hepatic fibrosis. There was no correlation between ALT, AST, TBIL, TP, ALP, GGT, or the four hepatic fibrosis markers in hepatoma caused by hepatitis B (P>0.05). Meanwhile, DBIL and TBA were positively correlated with CIV (DBIL: r=0.519, P=0.023; TBA: r=0.563, P=0.012), while CHE (r=-0.604, P=0.006), ALB (r=-0.564, P=0.012), and SOD (r=-0.489, P=0.034) were negatively correlated with CIV. Moreover, PA was negatively correlated with LN (r=-0.510, P=0.026) and CIV (r=-0.696, P=0.001).

CONCLUSIONS

The concentrations of the serological indices differed significantly based on the specific liver cirrhosis etiology. There was a strong correlation between the hepatic function indices and four hepatic fibrosis markers. Thus, the detection of these markers might improve the diagnosis and treatment of hepatoma.

摘要

背景

本研究旨在比较不同病因肝硬化患者的四种肝纤维化标志物[即透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原N端肽(PIIINP)和Ⅳ型胶原(CIV)]以及16项肝功能指标。

方法

采用自动生化分析仪和发光免疫分析仪对108例肝硬化合并肝癌患者的肝功能指标和肝纤维化标志物进行检测。纳入20名健康对照者,以比较不同病因肝硬化和肝癌之间的差异,并分析肝功能指标与纤维化标志物之间的相关性。

结果

乙型肝炎所致肝硬化患者的丙氨酸氨基转移酶(ALT)、总蛋白(TP)、碱性磷酸酶(ALP)或四种肝纤维化标志物之间无相关性(P>0.05)。天冬氨酸氨基转移酶(AST)与HA(r=0.428,P=0.007)、LN(r=0.458,P=0.004)和CIV(r=0.374,P=0.021)呈正相关。总胆红素(TBIL)和直接胆红素(DBIL)与LN(TBIL:r=0.480,P=0.002;DBIL:r=0.457,P=0.004)、PIIINP(TBIL:r=0.380,P=0.017;DBIL:r=0.406,P=0.011)和CIV(TBIL:r=0.415,P=0.010;DBIL:r=0.400,P=0.013)呈正相关。总胆汁酸(TBA)和γ-谷氨酰转肽酶(GGT)与PIIINP(TBA:r=0.363,P=0.025;GGT:r=0.353,P=0.029)和CIV(TBA:r=0.419,P=0.

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