YKL-40、GP73、LN、PⅢNP、ⅣC与慢性乙型肝炎病毒感染患者病情的关系

Relationships between YKL-40, GP73, LN, PⅢNP and ⅣC and the severity of chronic hepatitis B virus infection

    摘要
  • 摘要:
    目的 探讨甲壳质酶蛋白40(YKL-40)、高尔基体蛋白73(GP73)、层黏连蛋白(LN)、Ⅲ型前胶原氨基端肽(PⅢNP)、Ⅳ型胶原(ⅣC)与慢性乙型肝炎病毒(HBV)感染患者病情的关系。
    方法 选取2020年1月-2024年1月运城市中心医院收治的98例慢性HBV感染患者为研究组, 包括39例HBV携带患者(HBV携带组)、34例慢性乙型肝炎患者(慢性乙型肝炎组)、25例HBV相关肝硬化患者(HBV相关肝硬化组)。另随机选取同期医院健康体检的健康者98名为健康对照组。比较研究组、健康对照组, 不同病情慢性HBV感染者YKL-40、GP73、LN、PⅢNP、ⅣC水平, 分析五者联合检测对慢性HBV感染的诊断价值。采用Spearman法分析YKL-40、GP73、LN、PⅢNP、ⅣC水平与慢性HBV感染患者病情严重程度的相关性。
    结果 研究组血清YKL-40、GP73、LN、PⅢNP、ⅣC水平比健康对照组高(P＜0.05)。HBV相关肝硬化组血清YKL-40、GP73、LN、PⅢNP、ⅣC水平高于慢性乙型肝炎组和HBV携带组, 且慢性乙型肝炎组高于HBV携带组(P＜0.05)；Spearman相关分析发现, YKL-40、GP73、LN、PⅢNP、ⅣC水平与慢性HBV感染患者病情严重程度呈正相关(r =0.770；0.702；0.748；0.711；0.743, P＜0.05)；绘制受试者工作特征(ROC)曲线发现, YKL-40、GP73、LN、PⅢNP、ⅣC水平联合检测诊断慢性HBV感染的曲线下面积(AUC)比单独高(P＜0.05), 敏感度98.00%, 特异度72.40%。
    结论 YKL-40、GP73、LN、PⅢNP、ⅣC指标参与慢性HBV感染的发生, 且与患者病情严重程度有关, 五者联合检测有助于诊断慢性HBV感染。

     

    Abstract:
    OBJECTIVE To investigate the relationship between chitinase protein 40 (YKL-40), Golgi protein 73 (GP73), laminin (LN), type Ⅲ procollagen amino terminal peptide (PⅢNP) and type Ⅳ collagen (ⅣC) and the severity of chronic hepatitis B virus (HBV) infection.
    METHODS Ninety-eight patients with chronic HBV infection admitted to Yuncheng Central Hospital from Jan. 2020 to Jan. 2024 were selected as the study group, including 39 patients with HBV carrier status (the HBV carrier group), 34 patients with chronic hepatitis B (the chronic hepatitis B group), and 25 patients with HBV-related cirrhosis (the HBV-related cirrhosis group). Another 98 healthy subjects who underwent physical examination in our hospital during the same period were selected as the healthy control group. The levels of YKL-40, GP73, LN, ⅢNP and ⅣC were compared between the study and the healthy control group and among the subgroups with different severity, and the diagnostic value of the combination of the five indices in chronic HBV infection was analyzed. Spearman method was used to analyze the correlation between YKL-40, GP73, LN, PⅢNP, ⅣC levels and the severity of chronic HBV infection.
    RESULTS The levels of YKL-40, GP73, LN, PⅢNP and ⅣC in the study group were higher than those in the healthy control group (P < 0.05); and their levels in the HBV-related cirrhosis group were the highest in HBV subgroups, followed by those in the chronic hepatitis B group and those in the HBV carrier group (P < 0.05). Spearman correlation analysis found that, YKL-40, GP73, LN, PⅢNP and ⅣC levels were positively correlated with the severity of chronic HBV infection (r =0.770; 0.702; 0.748; 0.711; 0.743, respectively, P < 0.05). The receiver operating characteristic (ROC) curve showed that the combination of YKL-40, GP73, LN, PⅢNP and ⅣC had a higher area under the curve (AUC) in diagnosing chronic HBV infection than the index alone (P < 0.05), with the sensitivity of 98.00% and specificity of 72.40%.
    CONCLUSIONS YKL-40, GP73, LN, PⅢNP and ⅣC are involved in the occurrence of chronic HBV infection and related to the severity of patients′ disease. The combined detection of the five indices is helpful for the diagnosis of chronic HBV infection.

     

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