慢加急性肝衰竭前期患者血清M30和M65水平预测预后价值探讨

被引：6

作者：

黄小平 ^{[1
]}

吴云辉 ^{[2
]}

王艳 ^{[1
]}

甘建和 ^{[1
]}

机构：

[1] 苏州大学附属第一医院感染病科

[2] 浙江省嘉兴县人民医院感染病科

来源：

实用肝脏病杂志 | 2016年 / 19卷 / 03期

关键词：

慢加急性肝衰竭; 慢加急性肝衰竭前期; 早期诊断; M30抗原; M65抗原;

D O I：

暂无

中图分类号：

R575.3 [肝功能衰竭];

学科分类号：

100201 [内科学];

摘要：

目的探讨慢加急性肝衰竭前期(pre-ACLF)患者血清M30和M65水平在早期诊断慢加急性肝衰竭(ACLF)患者的价值。方法采用ELISA法检测35例pre-ACLF患者(痊愈20例、进展15例)、40例HBV相关ACLF患者(生存20例,死亡20例)、20例慢性乙型肝炎患者(CHB)和20例健康对照者血清M30和M65水平,分析其对pre-ACLF及ACLF患者临床转归的预测价值。结果 ACLF组和pre-ACLF组血清M30和M65水平均显著高于健康对照组或CHB患者,ACLF组显著高于pre-ACLF组(P<0.05);pre-ACLF进展组血清M30和M65[分别为(493.80±143.85)U/L和(712.47±305.67)U/L],与痊愈组[分别为(351.40±127.78)U/L和(448.15±165.14)U/L]比,差异具有统计学意义(P<0.05);pre-ACLF进展组与ACLF患者比,血清M30和M65水平[分别为(503.29±184.43)U/L和(746.99±275.19)U/L],均无显著性差异(P>0.05);以血清M30和M65水平鉴别诊断Pre-ACLF临床转归的ROC曲线下面积(AUC)分别为0.877和0.867;当M30≥453.70 U/L时,其预测预后的灵敏度和特异度分别为0.867和0.850;当M65≥626.71 U/L时,其早期预测ACLF的灵敏度和特异度分别为0.800和0.850。死亡的ACLF患者血清M30和M65水平虽高于ACLF好转组,但差异无统计学意义。结论 M30和M65是反应肝衰竭及肝衰竭前期患者肝细胞坏死或凋亡较敏感的指标,可用于早期诊断ACLF。

引用

页码：301 / 304

页数：4

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