慢性乙型肝炎肝纤维化患者的血浆CCL24水平及意义

目的探究慢性乙型肝炎(CHB)肝纤维化患者的血浆C-C基序趋化因子配体24(CCL24)水平及与肝纤维化程度的关系。方法选择2018年1月至2020年1月在云南省传染病医院确诊的143例CHB患者作为研究对象。采用酶联免疫吸附测定(ELISA)法检测血浆CCL24水平,分析其在显著肝纤维化和肝硬化评估中的价值。结果S4期CHB患者的血浆CCL24水平高于S0~S1期和S2~S3期CHB患者,差异均有统计学意义(P均<0.05)。S2~S3期CHB患者的血浆CCL24水平高于S0~S1期CHB患者,差异有统计学意义(P<0.05)。血浆CCL24水平与CHB患者肝纤维化病理分期呈正相关(P<0.05)。多因素Logistic回归分析结果显示,CCL24、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)和Ⅳ型胶原(ⅣC)水平均是显著肝纤维化的独立危险因素(P均<0.05),CCL24、HA和层粘连蛋白(LN)水平均是肝硬化的独立危险因素(P均<0.05)。模型X(CCL24、HA、PCⅢ和ⅣC联合检测)评价显著肝纤维化的受试者工作特征(ROC)曲线下面积(AUC)为0.991,大于APRI指数(0.781)和FIB-4指数(0.660),差异均有统计学意义(P均<0.05)。模型Y(CCL24、HA和LN联合检测)评价肝硬化的AUC为0.981,大于APRI指数(0.793)和FIB-4指数(0.641),差异均有统计学意义(P均<0.05)。结论CHB患者的血浆CCL24水平越高,其肝纤维化程度越严重。模型X和模型Y分别对显著肝纤维化和肝硬化的判断有较高价值。

Plasma CCL24 level and its significance in patients with chronic hepatitis B and liver fibrosis

Objective This paper intends to explore the relationship between plasma C-C motif chemokine ligand 24(CCL24)level and the degree of liver fibrosis in patients with chronic hepatitis B(CHB)liver fibrosis.Methods A total of 143 CHB patients diagnosed in Yunnan Provincial Hospital of Infectious Diseases from January 2018 to January 2020 were selected as the research objects.Enzyme-linked immunosorbent assay(ELISA)was used to detect plasma CCL24 levels and analyze its value in the evaluation of significant liver fibrosis and cirrhosis.Results The plasma CCL24 level of CHB patients in S4 stage was higher than that of patients in the S0~S1 and S2~S3 stages,with a statistically significant difference(all P<0.05).The plasma CCL24 level of CHB patients in the S2~S3 stage was higher than that in the S0~S1 stage,with a statistically significant difference(P<0.05).The level of plasma CCL24 was positively correlated with the pathological stage of liver fibrosis in CHB patients(P<0.05).The multivariate logistic regression analysis showed that CCL24,hyaluronic acid(HA),typeⅢprocollagen(PCⅢ),and typeⅣcollagen(ⅣC)levels were independent risk factors for significant liver fibrosis(all P<0.05),while CCL24,HA,and laminin(LN)levels were independent risk factors for liver cirrhosis(all P<0.05).When using model X(CCL24,HA,PCⅢ,andⅣC combined detection)to evaluate the receiver operating characteristic(ROC),the area under the curve(AUC)of significant liver fibrosis was 0.991,which was greater than the APRI index(0.781)and FIB-4 index(0.660),with a statistically significant difference(P<0.05),while using model Y(CCL24,HA and LN combined detection),the AUC of liver cirrhosis was 0.981,which was greater than the APRI index(0.793)and FIB-4 index(0.641),with a statistically significant difference(P<0.05).Conclusions The higher the plasma CCL24 level in CHB patients is,the more severe the degree of liver fibrosis is.Model X and model Y have higher value in judging significant liver fibrosis and liver cirrhosis,respectively.