CAJ | 학술논문

目的：定量检测肝硬化患者外周血清中可溶性CD163分子（sCD163）的表达水平，以探讨血清sCD163在肝硬化患者无创诊断及病程监测中的临床应用价值。方法收集肝硬化不同阶段患者外周血清41份及正常健康对照外周血清20份。采用酶联免疫吸附法（ELISA）定量检测肝硬化患者外周血清sCD163表达水平，并采用受试者工作曲线（ROC）分析其临床诊断价值。结果肝硬化患者外周血清sCD163水平明显高于健康对照组[（92.53±3.34）μg/L vs.（58.22±3.12）μg/L，P＜0.01]，且随着 Child-Pugh A、B、C 分级而增高[（76.99±4.46）μg/L vs.（99.69±4.04）μg/L vs.（112.90±3.59）μg/L，均P＜0.05]。与患者病因、有无再出血、有无门脉血栓形成及有无合并肝细胞性肝癌等无关，而与是否合并腹水或自发性细菌性腹膜炎（SBP）相关。外周血清sCD163的ROC曲线下面积为0.901，以80.12μg/L作为临界点，其诊断肝硬化的灵敏度为73.2%，特异度为95%。有腹水肝硬化患者外周血清sCD163的ROC曲线下面积为0.795，sCD163＞94.79μg/L预测肝硬化患者腹水生成的灵敏度和特异度分别为73.1%和80%。结论 sCD163作为巨噬细胞活化的标记物，在肝硬化患者外周血清中明显升高，且与肝硬化Child-Pugh分级有关，可作为肝硬化程度判断及病情监测的无创指标。血清sCD163水平与肝硬化相关并发症腹水和SBP的形成相关，提示其可能在肝硬化病程进展中发挥了一定的作用。
목적：정량검측간경화환자외주혈청중가용성CD163분자（sCD163）적표체수평，이탐토혈청sCD163재간경화환자무창진단급병정감측중적림상응용개치。방법수집간경화불동계단환자외주혈청41빈급정상건강대조외주혈청20빈。채용매련면역흡부법（ELISA）정량검측간경화환자외주혈청sCD163표체수평，병채용수시자공작곡선（ROC）분석기림상진단개치。결과간경화환자외주혈청sCD163수평명현고우건강대조조[（92.53±3.34）μg/L vs.（58.22±3.12）μg/L，P＜0.01]，차수착 Child-Pugh A、B、C 분급이증고[（76.99±4.46）μg/L vs.（99.69±4.04）μg/L vs.（112.90±3.59）μg/L，균P＜0.05]。여환자병인、유무재출혈、유무문맥혈전형성급유무합병간세포성간암등무관，이여시부합병복수혹자발성세균성복막염（SBP）상관。외주혈청sCD163적ROC곡선하면적위0.901，이80.12μg/L작위림계점，기진단간경화적령민도위73.2%，특이도위95%。유복수간경화환자외주혈청sCD163적ROC곡선하면적위0.795，sCD163＞94.79μg/L예측간경화환자복수생성적령민도화특이도분별위73.1%화80%。결론 sCD163작위거서세포활화적표기물，재간경화환자외주혈청중명현승고，차여간경화Child-Pugh분급유관，가작위간경화정도판단급병정감측적무창지표。혈청sCD163수평여간경화상관병발증복수화SBP적형성상관，제시기가능재간경화병정진전중발휘료일정적작용。
Objective To investigate the level of circulating soluble CD163 (sCD163) in liver cirrhosis, and to explore its diagnostic value as a noninvasive method. Methods The levels of sCD163 were quantitatively detected in 41 patients with liver cirrhosis and 20 health controls by ELISA, diagnostic value was analyzed by receive operating characteristic (ROC) curve, and its correlation with clinical pathological characters was also compared. Results The levels of serum sCD163 expression were significantly higher than those in healthy controls [(92.53±3.34)μg/L vs.(58.22±3.12)μg/L, P<0.001], and increased along with Child-Pugh classification [(76.99±4.46)μg/L vs.(99.69±4.04)μg/L vs.(112.90±3.59)μg/L, all P<0.05]. The expression of sCD163 closely related with complications like ascites and spontaneous bacterial peritonitis (SBP). Ascitic patients showed higher concentration of sCD163 than those without ascites [(100.70±3.36)μg/L vs.(78.39±5.43)μg/L, P<0.01], and correlated with the severity of ascites. Patients with SBP also exhibited higher circulating sCD163 level [(120.4±1.41)μg/L vs.(88.66±3.31)μg/L, P<0.01]. The area under ROC curve of sCD163 expression were 0.901. Taken 80.12μg/L as a critical point for sCD163, specificity predicting the diagnosis of liver cirrhosis was 95%. Also sCD163>80.12μg/L predicted the development of ascites with a sensitivity of 73.1%and specificity of 80%. Conclusion sCD163, as a marker of macrophage activation, increased significantly in patients with liver cirrhosis, which indicated that the levels of serum sCD163 expression could be a useful molecular marker for noninvasive diagnosis of liver cirrhosis. Furthermore, serum sCD163 level also associated with complications like ascites and SBP, which manifested that it may be involved in the progression of liver cirrhosis and can work as a method of monitoring the clinical disease course.