CAJ | 학술논문

目的：检测非酒精性脂肪肝病患者血清 PTX3脂肪因子水平，并探讨其在非酒精性脂肪肝病中的临床意义。方法用酶联免疫吸附法（ELISA）方法检测150例非酒精性脂肪肝病患者（其中单纯非酒精性脂肪肝98例，脂肪肝炎52例）以及120例健康对照组血清 PTX3脂肪因子水平，相关分析，多元逐步线性回归分析 PTX3脂肪因子相关参数，Logistic 回归分析脂肪肝炎危险因子、ROC 曲线对脂肪肝炎诊断效能。结果非酒精性脂肪肝病组血清中PTX3脂肪因子浓度均明显低于健康对照组；脂肪肝炎组PTX3脂肪因子浓度均明显低于单纯性非酒精性脂肪肝。Spearman′s 等级相关分析血清PTX3脂肪因子浓度与非酒精性脂肪肝病临床资料之间的相关性；Logistic 回归分析表明PTX3脂肪因子是非酒精性脂肪肝的保护因素，血清PTX3以及hsCRP/ PTX3脂肪因子的鉴别单纯非酒精性脂肪肝和脂肪肝炎ROC 曲线下面积分别为0.840和0.943，血清PTX3以及hsCRP/ PTX3脂肪因子的鉴别单纯非酒精性脂肪肝和脂肪肝炎最佳截点分别为1.45 ng/ m（l 敏感度为81.36％，特异度60.36％），0.939（敏感度为96.78％，特异度为77.11％）。结论血清PTX3脂肪因子与临床血脂、形态学指标密切相关，它是非酒精性脂肪肝保护因素，可用于单纯非酒精性脂肪肝和脂肪肝炎的鉴别诊断。
목적：검측비주정성지방간병환자혈청 PTX3지방인자수평，병탐토기재비주정성지방간병중적림상의의。방법용매련면역흡부법（ELISA）방법검측150례비주정성지방간병환자（기중단순비주정성지방간98례，지방간염52례）이급120례건강대조조혈청 PTX3지방인자수평，상관분석，다원축보선성회귀분석 PTX3지방인자상관삼수，Logistic 회귀분석지방간염위험인자、ROC 곡선대지방간염진단효능。결과비주정성지방간병조혈청중PTX3지방인자농도균명현저우건강대조조；지방간염조PTX3지방인자농도균명현저우단순성비주정성지방간。Spearman′s 등급상관분석혈청PTX3지방인자농도여비주정성지방간병림상자료지간적상관성；Logistic 회귀분석표명PTX3지방인자시비주정성지방간적보호인소，혈청PTX3이급hsCRP/ PTX3지방인자적감별단순비주정성지방간화지방간염ROC 곡선하면적분별위0.840화0.943，혈청PTX3이급hsCRP/ PTX3지방인자적감별단순비주정성지방간화지방간염최가절점분별위1.45 ng/ m（l 민감도위81.36％，특이도60.36％），0.939（민감도위96.78％，특이도위77.11％）。결론혈청PTX3지방인자여림상혈지、형태학지표밀절상관，타시비주정성지방간보호인소，가용우단순비주정성지방간화지방간염적감별진단。
Objective To detect the serum level of PTX3 in patients with non alcohol fatty liver disease,and to evaluate its clinical signif-icance. Methods Enzyme linked immunosorbent assay(ELISA)had been used to detect the serum level of PTX3 in 150 patients with non alcohol fatty liver disease(52 cases of nonalcoholic steatohepatitis,and 98 cases of simple steatosis)and 120 healthy controls;Spearman′s rank correlation had been used to analyze the relationship between PTX3 and other parameters. The analysis with multivariate binary logistic regression had been performed to evaluate the risk factors of nonalcoholic steatohepatitis. ROC curve had been constructed to compare the diagnostic power of parame-ters for nonalcoholic steatohepatitis. Results The average serum level of PTX3 in patients with non alcohol fatty liver disease was significantly low-er than that of healthy controls. The level of PTX3 in patients with non - alcoholic steatohepatitis was also lower than that of patients with simple steatosis. The analysis with multiple logistics regression showed that ANGPTL was independent protective factor for non alcohol fatty liver disease. The area under ROC curve used to distinguish nonalcoholic steatohepatitis from simple steatosis was 0. 840 for PTX3 and 0. 943 for hsCRP/ PTX3, with a cut - off value of 1. 45 ng/ ml(sensitivity:81. 36% ,specificity:60. 36% ),and 0. 939(sensitivity:96. 78% ;specificity:77. 11% ). Conclusion PTX3 is closely correlated to clinical parameters,and it is regarded as protective factor for a promising new biomarker to distinguish nonalcoholic steatohepatitis from simple steatosis,and it also has significant application value in diagnosis,monitoring and assessment of the dis-ease.