| 自身免疫性肝炎患者血清腺苷脱氨酶水平与肝组织炎症活动程度的关系及对治疗应答的影响* |
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| 引用本文： | 彭小燕,徐莉娟,刘鹏,祁双宝,孙一鸣. 自身免疫性肝炎患者血清腺苷脱氨酶水平与肝组织炎症活动程度的关系及对治疗应答的影响*[J]. 实用肝脏病杂志, 2019, 22(2): 200-203. DOI: 10.3969/j.issn.1672-5069.2019.02.012 |
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| 作者姓名： | 彭小燕 徐莉娟 刘鹏 祁双宝 孙一鸣 |
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| 作者单位： | 454000 河南省焦作市 河南省焦作煤业(集团)有限责任公司中央医院检验科（彭小燕,刘鹏,祁双宝,孙一鸣）; 郑州大学第一附属医院检验科（徐莉娟） |
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| 摘 要： | 目的 探究自身免疫性肝炎（AIH）患者血清腺苷脱氨酶（ADA)水平及其与肝组织炎症活动及预后的关系。方法 2013年4月~2016年5月我院收治的70例AIH患者,采用ELISA法检测血清ADA水平,常规行肝活检,应用受试者工作特征（ROC）曲线下面积（AUC）评价各指标诊断肝组织界面炎的效能,采用Logistic回归分析影响AIH患者对治疗应答不良的因素。结果 53例AIH活动期、17例缓解期患者和38例健康人血清ADA水平分别为（30.2±7.1） U/L、（16.5±4.3） U/L和（12.9±2.2） U/L,差异显著（P<0.05）;17例轻度、21例中度和32例重度肝组织界面炎患者血清ADA水平分别为（16.5±4.3） U/L、（26.0±4.7） U/L和（32.9±7.2） U/L,差异显著（P<0.05）;血清ADA诊断严重界面炎的曲线下面积（AUC）等于0.867（95%CI：0.764~0.936）,最佳截断点为22.1 U/L,其敏感度和特异性分别为100.0%和63.2%;单因素分析显示女性、血清ADA、ALT、AST、TBIL、GGT、ALP、IgG、IgM水平、抗gp210抗体阳性和肝硬化可能与AIH患者对治疗应答不良有关,经Logistic回归分析显示血清ADA、ALP和肝硬化是AIH患者对治疗应答不良的危险因素。结论 AIH患者血清ADA水平与肝组织炎症活动度密切相关,并可能影响对治疗的应答,可协助预判对治疗的应答反应,从而可帮助选择合适的治疗患者。
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| 关 键 词： | 自身免疫性肝炎 腺苷脱氨酶 肝组织炎症 皮质激素 治疗应答 |
| 收稿时间： | 2018-08-20 |
Changes of serum adenosine deaminase levels in patients with autoimmune hepatitis and its correlation to hepatic activity index and response to steroid therapy |
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| Peng Xiaoyan,Xu Lijuan,Liu Peng,Qi Shuangbao,Sun Yiming. Changes of serum adenosine deaminase levels in patients with autoimmune hepatitis and its correlation to hepatic activity index and response to steroid therapy[J]. Journal of Clinical Hepatology, 2019, 22(2): 200-203. DOI: 10.3969/j.issn.1672-5069.2019.02.012 |
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| Authors: | Peng Xiaoyan Xu Lijuan Liu Peng Qi Shuangbao Sun Yiming |
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| Affiliation: | Clinical Laboratory,Central Hospital,Coal Industry Group Co.,Ltd.,Jiaozuo 454000,Henan Province,China |
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| Abstract: | Objective To investigate the changes of serum adenosine deaminase（ADA） levels in patients with autoimmune hepatitis（AIH） and its correlation to hepatic activity index and response to steroid therapy. Methods 70 patients with AIH were enrolled in our hospital between April 2013 and May 2016,all patients received liver biopsies under US guidance and serum ADA levels were detected by ELISA. The area under ROC was applied to evaluate the efficacy of every parameter for the diagnosis of hepatic interfacial inflammation and the influencing factors for non-response to steroid therapy was made by Logistic analysis. Results Serum ADA levels in 53 patients with active AIH,17 at remission and 38 healthy persons were （30.2±7.1）U/L,（16.5±4.3）U/L and （12.9±2.2） U/L,and the differences were significant （P<0.05）;serum ADA levels in 17 patients with mild,21 with moderate and 32 with severe hepatic interfacial inflammation were（16.5±4.3） U/L,（26.0±4.7） U/L and （32.9±7.2） U/L,and the differences were statistically significant（P<0.05）;the AUC for serum ADA to diagnose the interfacial inflammation was 0.867（95%CI：0.764-0.936）,the cut-off-value was 22.1 U/L,the sensitivity and specificity were 100.0% and 63.2%;univariate analysis showed that female,serum ADA,ALT,AST,TBIL,GGT,ALP,IgG,IgM,anti-gp210 positive and cirrhosis were related to non-response to steroid therapy and the Logistic analysis demonstrated that serum ADA,ALP and liver cirrhosis were the independent factors for failed steroid therapy. Conclusion Serum ADA levels in patients with AIH is closely related to hepatic activity index, which might be helpful in predicting the response of patients with AIH to steroid therapy. |
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| Keywords: | Autoimmune hepatitis Adenosine deaminase Hepatic activity index Steroid therapy Response |
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