摘要
目的分析血清壳多糖酶3样蛋白1(CHI3L1)无创诊断模型在乙型肝炎e抗原(HBe Ag)阴性慢性乙型肝炎肝纤维化中的应用研究。方法选择2019年1月-10月在本院就诊的HBe Ag阴性慢性乙型肝炎(CHB)患者70例为研究组,同期选择20例正常者为对照组。建立CHI3L1对HBe Ag阴性慢性乙型肝炎肝纤维化无创诊断的模型,并评价该模型对不同病理分期肝纤维化的区分能力及对各个肝纤维化病理分期的诊断价值。结果对照组与不同肝纤维化分期患者血清CHI3L1表达水平差异有统计学意义(P<0.05),F3患者血清CHI3L1表达水平高于F0~2分期患者及对照组受试者(P<0.05);CHI3L1模型对HBe Ag阴性CHB患者肝纤维化诊断标准误为0.064%,AUC为0.759,样本率标准误为75.7%,准确率为78.9%,阳性预测值为78.2%,阴性预测值为76.5%。结论 CHI3L1在无创诊断肝纤维化有较高价值,有利于HBe Ag阴性CHB患者肝纤维化筛查,避免因患者拒绝活检而引起的漏诊病例,防止严重肝病发生。
Objective To investigate the application of chitinase-3-like protein 1(CHI3 L1) noninvasive model in the diagnosis of hepatic fibrosis in patients with hepatitis B e antigen(HBe Ag)-negative chronic hepatitis B(CHB).Methods A total of 70 patients with HBe Ag-negative CHB(study group) and 20 healthy individuals(control group) in our hospital were enrolled from January to October in 2019.The hepatic fibrosis of study group was assessed by CHI3 L1 noninvasive model.The value of the model in distinguishing liver fibrosis in different pathological stages and each pathological stage was analyzed.Results There was statistical significance on the difference in the serum CHI3 L1 expression between control group and patients with different stages of liver fibrosis(P<0.05).Serum CHI3 L1 expression of patients in F3 stage was higher than that of F0-2 stage and control group(P<0.05).The diagnostic SE,AUC,SP,AC,PPV and NPV of CHI3 L1 noninvasive model for HBe Ag-negative CHB patients were 0.064%,0.759,75.7%,78.9%,78.2% and 76.5%,respectively.Conclusion CHI3 L1 has high value in non-invasive diagnosis of liver fibrosis,which is conducive to liver fibrosis screening in patients with HBe Ag negative CHB,avoiding missed diagnosis cases caused by patients refusing biopsy,and preventing the occurrence of serious liver disease.
作者
李月翠
胡伟跃
徐象威
陈豪
LI Yue-cui;HU Wei-yue;XU Xiang-wei;CHEN Hao(Department of Infectious Disease,First People’s Hospital of Yongkang,Yongkang,Zhejiang 321300,China)
出处
《中国卫生检验杂志》
CAS
2021年第12期1460-1463,共4页
Chinese Journal of Health Laboratory Technology
基金
浙江省卫生科技项目(2019KY764)。
作者简介
李月翠(1972-),女,本科,主任医师,主要从事感染病方面的研究。
