Department of Infectious Diseases, Shenzhen Hospital, Peking University, Shenzhen, China.
Medicine (Baltimore). 2024 Jun 7;103(23):e38342. doi: 10.1097/MD.0000000000038342.
In this study, we aimed to explore the clinical significance of serum CK18-M65 and CK18-M30 levels in patients with chronic hepatitis B (CHB) complicated by nonalcoholic steatohepatitis (NASH) and liver fibrosis. The observation and control groups comprised 133 patients with CHB complicated by NASH and 50 healthy patients from our hospital, respectively. Liver function indices, including alanine aminotransferase, glutamic aminotransferase, γ-glutamyltransferase, total bilirubin, total protein, and total cholesterol, were determined using an automatic biochemical analyzer. Hyaluronic acid, type III procollagen, type IV collagen, laminin, and CK18-M65 and M30 levels were detected using ELISA. Serum CK18-M65 and M30 levels in patients with CHB complicated by NASH were positively correlated with the liver fibrosis stage (P < .05). While serum CK18-M65 demonstrated a low diagnostic value for liver fibrosis in the S0-1 stage, it exhibited good diagnostic value for S2-3 stage liver fibrosis. Serum CK18-M30 displayed good diagnostic value for S0-1 and S2-3 hepatic fibrosis, particularly for S2-3 hepatic fibrosis. Elevated serum CK18-M65 and CK18-M30 levels in patients with CHB complicated with NASH suggest their potential utility in evaluating the progression of liver fibrosis in this population. In particular, CK18-M30 exhibits superior diagnostic efficiency.
在这项研究中,我们旨在探讨慢性乙型肝炎(CHB)合并非酒精性脂肪性肝炎(NASH)和肝纤维化患者血清 CK18-M65 和 CK18-M30 水平的临床意义。观察组包括 133 例我院 CHB 合并 NASH 患者,对照组包括 50 例健康患者。采用自动生化分析仪检测丙氨酸氨基转移酶、谷氨酸氨基转移酶、γ-谷氨酰转移酶、总胆红素、总蛋白和总胆固醇等肝功能指标。采用 ELISA 法检测透明质酸、III 型前胶原、IV 型胶原、层粘连蛋白和 CK18-M65、M30 水平。CHB 合并 NASH 患者血清 CK18-M65 和 M30 水平与肝纤维化分期呈正相关(P<0.05)。血清 CK18-M65 对 S0-1 期肝纤维化诊断价值较低,对 S2-3 期肝纤维化诊断价值较好。血清 CK18-M30 对 S0-1 和 S2-3 期肝纤维化具有良好的诊断价值,尤其对 S2-3 期肝纤维化。CHB 合并 NASH 患者血清 CK18-M65 和 CK18-M30 水平升高提示其在评估该人群肝纤维化进展方面具有潜在的应用价值。特别是 CK18-M30 具有更高的诊断效率。