血清壳多糖酶3样蛋白1、肝纤维化4项及AFP的检测在不同肝脏疾病中的应用价值探讨

目的探讨血清壳多糖酶3样蛋白1(CHI3L1)、肝纤维化4项及甲胎蛋白(AFP)在不同肝脏疾病中的应用价值。方法选取172例符合条件的慢性乙型肝炎病毒感染者,分为慢性乙型肝炎组、肝硬化组和肝癌组。收集同期健康体检者30例作为正常对照组。比较各组间指标的差异,采用受试者工作特征(ROC)曲线分析各指标鉴别诊断效能。采用Spearman秩相关分析各指标与疾病严重程度的相关性。结果血清CHI3L1及肝纤维化4项在肝硬化组和肝癌组明显高于慢性乙型肝炎组和正常对照组(P <0.05)。血清AFP浓度在肝癌组明显高于其他各组,上述差异均有统计学意义(P <0.01),其诊断肝癌的AUC为0.912。ROC曲线分析显示CHI3L1在肝硬化组和慢性乙型肝炎组,慢性乙型肝炎组和正常对照组之间的鉴别诊断效能较好,AUC分别为0.853和0.845。Spearman相关性分析显示肝脏疾病的严重程度与各血清学指标均呈正相关(P <0.05)。结论 CHI3L1、肝纤维化4项及AFP的检测可以辅助诊断慢性肝炎及其肝纤维化导致的肝硬化等不同肝脏疾病,值得在临床推广和进一步的研究。

Study on the application value of serum chitosan enzyme 3-like protein 1,liver fibrosis 4 items and AFP detection in different liver diseases

Objective To investigate the determination of serum chitinase 3-like protein 1(CHI3L1),hyaluronic acid(HA),laminin(LN),Ⅲ-procollagen(PC Ⅲ),Ⅳ-collagen(Ⅳ-C) and alpha fetoprotein(AFP) for the application in patients with different liver diseases. Methods A total of 172 patients with chronic hepatitis B infection were selected and divided into chronic hepatitis B group,liver cirrhosis group and liver cancer group. 30 healthy subjects in the same period were treated as control group. The serum CHI3L1,HA,LN,PC Ⅲ,Ⅳ-C and AFP levels were compared among different groups. Receiver operating characteristic(ROC) curve was used to analyze the efficacy of CHI3L1,HA,LN,PC Ⅲ,Ⅳ-C and AFP in the diagnosis and antidiastole between different groups. Results The levels of CHI3L1,HA,LN,PC Ⅲ and Ⅳ-C were significantly higher in liver cirrhosis group and liver cancer group than that in chronic hepatitis B group and control group(P < 0. 05). The level of AFP was significantly higher in liver cancer group than that in other groups,with the difference statistically significant(P < 0. 01),and the AUC of AFP in the diagnosis of liver cancer was 0. 912. ROC curve showed that the AUC of CHI3L1 in the antidiastole between liver cirrhosis group and chronic hepatitis B group was 0. 853,and the AUC between chronic hepatitis B group and control group was 0. 845,both of which have good antidiastole efficacy. Spearman correlation analysis showed that the severity of liver disease was positively correlated with each serological indicators(P < 0. 05). Conclusion CHI3L1,HA,LN,PC Ⅲ,Ⅳ-C and AFP can be used as diagnostic and antidiastole parameters for different liver diseases and is worthy of further study.