血清sP-selectin、sICAM-1和免疫球蛋白检测对乙肝肝硬化预后评估的意义

发布时间：2018-03-16 22:12

  本文选题：血清sP-selectin　切入点：sICAM-　出处：《中国免疫学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的:旨在探讨血清sP-selectin、sICAM-1和免疫球蛋白检测对乙肝肝硬化预后评估的意义。方法:选取池州市人民医院于2014年1月~2016年12月收治的162例乙肝肝硬化患者作为研究对象,分别测定患者血清可溶性P-选择素(sP-selectin)、可溶性细胞间黏附分子-1(sICAM-1)、免疫球蛋白和相关血清指标。比较不同肝硬化患者和肝癌患者血清指标差异性,Pearson分析血清可溶性P-选择素(sP-selectin)、可溶性细胞间黏附分子-1(sICAM-1)、免疫球蛋白和相关血清指标相关性,logistic多因素回归分析肝硬化转肝癌危险因素,受试者工作特征(ROC)曲线评价OR1参数对肝硬化转肝癌预测价值。结果:原发性肝癌患者sP-selectin、sICAM-1、IgM、IgG、IgA显著高于代偿期肝硬化和失代偿期肝硬化患者(P0.05)。失代偿期肝硬化患者sP-selectin、sICAM-1、IgM、IgG、IgA显著高于代偿期肝硬化患者(P0.05)。不同Child-Pugh分级肝硬化患者中,C级患者sP-selectin、sICAM-1、IgM、IgG、IgA显著高于B级和A级患者(P0.05)。B级患者sP-selectin、sICAM-1、IgM、IgG、IgA显著高于A级患者(P0.05)。多发癌灶患者和单发癌灶原发性肝癌患者sP-selectin、sICAM-1和免疫球蛋白表达差异无统计学意义(P0.05)。Ⅱ期原发性肝癌患者sP-selectin、sICAM-1和免疫球蛋白显著高于Ⅰ期患者(P0.05)。肝硬化患者sP-selectin、sICAM-1、免疫球蛋白之间均互为正相关性(P0.05)。以肝硬化是否转原发性肝癌为因变量进行多因素Logistic回归分析,结果显示,ALT、AST、sP-selectin、sICAM-1、IgM、IgG、IgA均是肝硬化转原发性肝癌的危险因素。ROC曲线分析可得,sICAM-1和sP-selectin诊断肝硬化转肝癌敏感性和特异性均高于其他因素。结论:血清sP-selectin、sICAM-1对乙肝肝硬化预后评估具有较高临床诊断精度,对肝硬化转原发性肝癌的诊断特异度、敏感度高于单纯免疫球蛋白检测,故其联合检测诊断肝硬化预后值得临床推广。
[Abstract]:Objective: to investigate the significance of serum sP-selectinus sICAM-1 and immunoglobulin in evaluating the prognosis of hepatitis B cirrhosis. Methods: 162 patients with hepatitis B cirrhosis admitted in Chizhou people's Hospital from January 2014 to December 2016 were selected as study subjects. Serum soluble P- selectin, soluble intercellular adhesion molecule-1, immunoglobulin and related serum indexes were measured respectively. The difference of serum levels between different liver cirrhosis patients and liver cancer patients was compared. Pearson analysis of serum soluble P-. SP-selectinus, soluble intercellular adhesion molecule-1 (sICAM-1), immunoglobulin and related serum markers were correlated with logistic multivariate regression analysis for the risk factors of liver cirrhosis to liver cancer. Results: the sP-selectinus sICAM-1 IgMM-1 IgGG OR1 in patients with primary liver cancer was significantly higher than that in patients with compensatory cirrhosis and decompensated cirrhosis (P0.05A). SP-selectinus sICAM-1IgMM-1IgMGG A in patients with decompensated cirrhosis was significantly higher than that in patients with compensatory cirrhosis and decompensated cirrhosis (P < 0.05). SP-selectinus sICAM-1 IgMN IgGA in patients with different Child-Pugh grade cirrhosis was significantly higher than that in patients with grade B and grade A (P0.05) and sP-selectinine sICAM-1 IgMG IgA was significantly higher than that in grade A patients with multiple carcinomas and primary hepatocellular carcinoma (P0.05). The expression of sP-selectinus sICAM-1 and immunoglobulin in patients with stage 鈪，

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