中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2015年
2期
99-103
,共5页
非酒精性脂肪性肝病%诊断,鉴别%角蛋白18%抗原,CD95%凋亡
非酒精性脂肪性肝病%診斷,鑒彆%角蛋白18%抗原,CD95%凋亡
비주정성지방성간병%진단,감별%각단백18%항원,CD95%조망
Nonalcoholic fatty liver disease%Diagnosis,differential%Keratin-18%Antigens,CD95%Apoptosis
目的 探讨细胞角蛋白18片段M30 (CK18 M30)和Fas水平在非酒精性脂肪性肝病(NAFLD),尤其是非酒精性脂肪性肝炎(NASH)中的诊断价值.方法 共纳入58例NAFLD患者,其中36例NAFLD患者接受了肝活组织检查,根据NAFLD活动度积分(NAS)和肝纤维化分期,分为NASH组(24例)和非NASH组(12例).将同期15名健康体检者作为健康对照组.采用ELISA法检测受试者血清中的CK18-M30和Fas水平.评估组间CK18-M30和Fas的水平差异采用秩和检验,用ROC曲线评估CK18-M30、Fas在NASH中的诊断价值.结果 NAFLD组患者血清CK18-M30的水平高于健康对照组[97.24(86.06,113.12) U/L比78.41(74.29,80.76) U/L,Z=4.206,P＜0.01];NASH组患者血清中的CK18-M30水平高于非NASH组[111.06(94.30,142.68) U/L比89.00(83.56,106.50) U/L,Z=-2.233,P＜0.05].CK18 M30诊断NASH的ROC曲线的AUC值为0.73(0.56,0.90),诊断NASH的敏感度和特异度分别为79.2％和58.3％,Fas诊断NASH的AUC值为0.58(0.38,0.77),诊断NASH的敏感度和特异度分别是54.2％和66.7％.NAFLD组与健康对照组、NASH组与非NASH组相比血清Fas水平升高,但差异均无统计学意义(P均＞0.05).结论 血清CK18-M30的水平对于NASH的诊断有一定价值.Fas对NASH的诊断价值有待扩大样本量后进一步研究.
目的 探討細胞角蛋白18片段M30 (CK18 M30)和Fas水平在非酒精性脂肪性肝病(NAFLD),尤其是非酒精性脂肪性肝炎(NASH)中的診斷價值.方法 共納入58例NAFLD患者,其中36例NAFLD患者接受瞭肝活組織檢查,根據NAFLD活動度積分(NAS)和肝纖維化分期,分為NASH組(24例)和非NASH組(12例).將同期15名健康體檢者作為健康對照組.採用ELISA法檢測受試者血清中的CK18-M30和Fas水平.評估組間CK18-M30和Fas的水平差異採用秩和檢驗,用ROC麯線評估CK18-M30、Fas在NASH中的診斷價值.結果 NAFLD組患者血清CK18-M30的水平高于健康對照組[97.24(86.06,113.12) U/L比78.41(74.29,80.76) U/L,Z=4.206,P＜0.01];NASH組患者血清中的CK18-M30水平高于非NASH組[111.06(94.30,142.68) U/L比89.00(83.56,106.50) U/L,Z=-2.233,P＜0.05].CK18 M30診斷NASH的ROC麯線的AUC值為0.73(0.56,0.90),診斷NASH的敏感度和特異度分彆為79.2％和58.3％,Fas診斷NASH的AUC值為0.58(0.38,0.77),診斷NASH的敏感度和特異度分彆是54.2％和66.7％.NAFLD組與健康對照組、NASH組與非NASH組相比血清Fas水平升高,但差異均無統計學意義(P均＞0.05).結論 血清CK18-M30的水平對于NASH的診斷有一定價值.Fas對NASH的診斷價值有待擴大樣本量後進一步研究.
목적 탐토세포각단백18편단M30 (CK18 M30)화Fas수평재비주정성지방성간병(NAFLD),우기시비주정성지방성간염(NASH)중적진단개치.방법 공납입58례NAFLD환자,기중36례NAFLD환자접수료간활조직검사,근거NAFLD활동도적분(NAS)화간섬유화분기,분위NASH조(24례)화비NASH조(12례).장동기15명건강체검자작위건강대조조.채용ELISA법검측수시자혈청중적CK18-M30화Fas수평.평고조간CK18-M30화Fas적수평차이채용질화검험,용ROC곡선평고CK18-M30、Fas재NASH중적진단개치.결과 NAFLD조환자혈청CK18-M30적수평고우건강대조조[97.24(86.06,113.12) U/L비78.41(74.29,80.76) U/L,Z=4.206,P＜0.01];NASH조환자혈청중적CK18-M30수평고우비NASH조[111.06(94.30,142.68) U/L비89.00(83.56,106.50) U/L,Z=-2.233,P＜0.05].CK18 M30진단NASH적ROC곡선적AUC치위0.73(0.56,0.90),진단NASH적민감도화특이도분별위79.2％화58.3％,Fas진단NASH적AUC치위0.58(0.38,0.77),진단NASH적민감도화특이도분별시54.2％화66.7％.NAFLD조여건강대조조、NASH조여비NASH조상비혈청Fas수평승고,단차이균무통계학의의(P균＞0.05).결론 혈청CK18-M30적수평대우NASH적진단유일정개치.Fas대NASH적진단개치유대확대양본량후진일보연구.
Objective To assess the diagnostic value of cytokeratin 18 fragment M30 (CK18-M30) and Fas in patients with nonalcoholic fatty liver disease (NAFLD),especially nonalcoholic steatohepatitis (NASH).Methods Among 58 patients with NAFLD,36 patients with NAFLD received liver biopsy.According to NAFLD activity score (NAS) and liver fibrosis score,patients were divided into NASH group (24 cases) and non-NASH group (12 cases).And at the same period,15 healthy individuals were set as healthy control group.The serum level of CK18 M30 and Fas were measured with enzyme-linked immunosorbant assay (ELISA).Rank sum test was performed to analyze the differences in the level of CK18-M30 and Fas between groups.The diagnostic value of CK18 M30 and Fas were assessed by the receiver operating characteristic (ROC) curves.Results The level of serum CK18-M30 of NAFLD group was significantly higher than that of healthy control group (97.24 U/L (86.06 to 113.12 U/L) vs 78.41 U/L (74.29 to 80.76 U/L),Z=-4.206,P＜0.01)).The level of serum CK18-M30 of NASH group was higher than that of non-NASH group (111.06 U/L (94.30 to 142.68 U/L) vs 89.00 U/L (83.56 to 106.50 U/L),Z=-2.233,P＜0.05)).The area under the ROC curve (AUC) of CK18-M30 in the diagnosis of NASH was 0.73 (0.56,0.90),and the sensitivity and specificity of CK18-M30 in diagnosis of NASH was 79.2％ and 58.3％,respectively.The AUC of Fas in diagnosis of NASH was 0.58 (0.38,0.77),while the sensitivity and specificity of Fas in diagnosis of NASH was 54.2％ and 66.7 ％.The serum level of Fas increased in FAFLD group compared with healthy control group,and in NASH group compared with non-NASH group,however the differences were not signifincant (both P＞ 0.05).Conclusions The level of CK18-M30 has certain value in the diagnosis of NASH.The diagnostic value of Fas in NASH needs more samples in further study.
