摘要
目的分析不同Child-Pugh分级肝硬化患者血清凝血酶敏感蛋白-1(TSP-1)、球蛋白/胆碱酯酶的表达水平差异及其疾病预后危险因素。方法回顾性选取2020年2月至2023年2月新疆医科大学第一附属医院收治的70例肝硬化患者作为主要研究对象,根据Child-Pugh分级将其分为Child-Pugh A级组(n=20),Child-Pugh B级组(n=34),Child-Pugh C级组(n=16),另选取同期在本院进行体检的50名健康人群作为对照组。采用酶联免疫吸附试验法检测4组及肝硬化不同预后患者的血清TSP-1、球蛋白、胆碱酯酶、球蛋白/胆碱酯酶表达水平;采用双变量Spearman相关性检验血清TSP-1、球蛋白、胆碱酯酶、球蛋白/胆碱酯酶与肝硬化患者Child-Pugh分级和预后的相关性;建立多因素Logistic模型分析影响肝硬化患者预后的独立危险因素,并绘制受试者工作特征(ROC)曲线分析血清TSP-1、球蛋白/胆碱酯酶对肝硬化预后的预测价值。结果与对照组比较,Child-Pugh A级组、Child-Pugh B级组、Child-Pugh C级组患者的血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低;与Child-Pugh A级组患者比较,Child-Pugh B级组、Child-Pugh C级组患者的血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低;与Child-Pugh B级组比较,Child-Pugh C级组患者的血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低,差异均有统计学意义(P<0.05)。与预后良好组比较,预后不良组血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低,差异均有统计学意义(P<0.05)。肝硬化患者血清TSP-1、球蛋白/胆碱酯酶与Child-Pugh分级和预后均呈正相关(P<0.05)。多因素Logistic分析结果显示,Child-Pugh分级、TSP-1、球蛋白/胆碱酯酶均是影响肝硬化患者预后的独立危险因素(P<0.05)。血清TSP-1、球蛋白/胆碱酯酶与TSP-1+球蛋白/胆碱酯酶预测肝硬化患者预后的曲线下面积值分别为0.814、0.824、0.885。结论血清TSP-1、球蛋白/胆碱酯酶异常表达与肝硬化Child-Pugh分级及其预后均存在一定关联,可作为肝硬化患者的Child-Pugh分级及预后的辅助预测指标。
Objective To analyze the expression levels of serum thrombospondin-1(TSP-1)and globulin/cholinesterase in patients with liver cirrhosis of different Child-Pugh grades and their prognostic risk factors.Methods Seventy patients with liver cirrhosis admitted to The First Affiliated Hospital of Xinjiang Medical University from February 2020 to February 2023 were retrospectively selected as the main research objects.According to Child-Pugh classification,they were divided into Child-Pugh class A group(n=20),Child-Pugh class B group(n=34)and Child-Pugh class C group(n=16).In addition,50 healthy people who underwent physical examination in The First Affiliated Hospital of Xinjiang Medical University during the same period were selected as the control group.The expression levels of serum TSP-1 and globulin/cholinesterase in 4 groups and patients with different prognosis of liver cirrhosis were detected by enzyme-linked immunosorbent assay.Bivariate Spearman correlation was used to test the correlation between serum TSP-1,globulin/cholinesterase and Child-Pugh classification and prognosis in patients with liver cirrhosis.The independent risk factors affecting the prognosis of patients with liver cirrhosis was analyzed by establishing multivariate Logistic model,and the predictive value of serum TSP-1 and globulin/cholinesterase on the prognosis of liver cirrhosis was analyzed by plotting receiver operating characteristic(ROC)curve.Results Compared with the control group,the expression levels of serum TSP-1,globulin and globulin/cholinesterase in patients with Child-Pugh class A group,Child-Pugh class B group and Child-Pugh class C group were higher,and the expression level of serum cholinesterase was lower;compared with patients with Child-Pugh class A group,the expression levels of serum TSP-1,globulin and globulin/cholinesterase in patients with Child-Pugh class B group and Child-Pugh class C group were higher,and the expression level of serum cholinesterase was lower;compared with Child-Pugh class B group,the expression levels of serum TSP-1,globulin and globulin/cholinesterase in patients with Child-Pugh class C group were higher,and the expression level of serum cholinesterase was lower,the differences were statistically significant(P<0.05).Compared with the good prognosis group,the expression levels of serum TSP-1,globulin,globulin/cholinesterase in the poor prognosis group were higher,and the expression level of serum cholinesterase was lower,the differences were statistically significant(P<0.05).There was a positive correlation between serum TSP-1,globulin/cholinesterase Child-Pugh classification and prognosis in patients with liver cirrhosis(P<0.05).Multivariate Logistic analysis showed that Child-Pugh classification,TSP-1 and globulin/cholinesterase were independent risk factors affecting the prognosis of patients with cirrhosis(P<0.05).The area under the curve values of serum TSP-1,globulin/cholinesterase and TSP-1+globulin/cholinesterase in predicting the prognosis of patients with cirrhosis were 0.814,0.824 and 0.885,respectively.Conclusion The abnormal expression of serum TSP-1 and globulin/cholinesterase is related to the Child-Pugh classification and prognosis of cirrhosis,which can be used as an auxiliary predictor of Child-Pugh classification and prognosis in patients with cirrhosis.
作者
葛爽
魏娟
谷申森
GE Shuang;WEI Juan;GU Shen-sen(Liver Laparoscopic Surgery,The First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830000,China)
出处
《临床和实验医学杂志》
2024年第2期126-130,共5页
Journal of Clinical and Experimental Medicine
基金
新疆维吾尔自治区自然科学基金资助项目(编号:2021D01C304)。
作者简介
通信作者:谷申森,Email:gs_15099173653@163.com。
