| 胡溢博.血清趋化素与自身免疫性肝炎的相关性[J].安徽医药,2021,25(9):1812-1816. |
| 血清趋化素与自身免疫性肝炎的相关性 |
| Association between serum adipokine chemerin in patients with autoimmune hepatitis |
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| DOI：10.3969/j.issn.1009-6469.2021.09.027 |
| 中文关键词: 肝炎，自身免疫性 趋化素 检测水平 临床意义 |
| 英文关键词: Hepatitis, autoimmune Adipokine chemerin Detection level Clinical significance |
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| 中文摘要: |
| 目的探讨血清趋化素与自身免疫性肝炎( AIH)的关联性。方法 2017年 10月至 2018年 10月在郑州大学第二附属医院门诊体检及就诊的健康体检者 70例为对照组，以酒精性肝病( ALD)病人 63例为 ALD组、 AIH 68例为 AIH组，采用密度梯度离心法分离外周血单个核细胞，采用流式细胞仪检测 Th1、Th2、Th17和调节性 T细胞( Treg)表达水平，采用酶联免疫吸附测定检测干扰素 γ、白细胞介素 -4(IL-4)、转化生长因子 β(TGF-β)和白细胞介素 -17(IL-17)等相关细胞因子表达水平，以及趋化素水平。 Pearson相关性分析检验血清趋化素与 CD4+T细胞亚群及血清细胞因子表达量之间的相关性。多因素 logistic回归分析自身免疫性肝炎病人的影响因素。受试者工作特征曲线( ROC)评价血清趋化素表达水平对 AIH的诊断价值。结果对照组、 ALD组和 AIH组血清趋化素水平依次为( 73.88±21.69)mmHg、(89.57±23.58)mmHg、(122.69±31.86)mmHg(P<0.05)。与对照组相比， ALD组、 AIH病人组 Th1和 Th17，血清中干扰素 γ和 IL-17、趋化素显著升高( P<0.05)，Th2及 Treg细胞比例显著降低(P<0.05)；与 ALD组相比， AIH病人组 Th1和 Th17，血清中干扰素 γ和 IL-17、趋化素明显升高( P<0.05)Th2及 Treg细胞比例明显降低( P<0.05)。 Pearson分析结果显示，血清趋化素与 Th1、Th17、干扰素 γ、IL-17细胞及细胞因子表达，量之间均呈正相关关系( P<0.05)与 Th2、Treg细胞表达量均呈负相关关系( P<0.05)。多因素 logistic回归分析显示， Th1、Th2、Treg、Th17、干扰素 γ、 IL-17、趋化素是，AIH的独立危险因素( P<0.05)。 ROC曲线分析显示，以对照组为参考，血清中趋化素水平对 AIH诊断价值的曲线下面积( AUC)为 0.857(95%CI:0.792~0.921)，截断值为 94.15 mmHg，其灵敏度、特异度分别为 80.9%、88.4%；以 ALD组为参考，则血清中趋化素水平对 AIH诊断价值的 AUC为 0.703(95%CI:0.614~0.793)，截断值为 116.95 mmHg，其灵敏度、特异度分别为 57.4%、81.2%。结论血清趋化素水平升高为 AIH独立危险因素，可能成为 AIH较好的辅助诊断指标。 |
| 英文摘要: |
| Objective To investigate the relationship between serum chemerin and autoimmune hepatitis (AIH).Methods Seventyhealthy subjects who underwent physical examination and medical examination in the Second Affiliated Hospital of Zhengzhou University from October 2017 to October 2018 were selected as the control group, 63 patients with alcoholic liver disease (ALD) were selectedas the ALD group and 68 patients with AIH were designated as AIH group. Peripheral blood mononuclear cells were separated by density gradient centrifugation, the expression levels of T helper cell 1 (Th1), T helper cell 2 (Th2), T helper cell 17 (Th17) and regulatoryT-cell (Treg) were detected by flow cytometry, the expression levels of IFN-γ, interleukin-4 (IL-4), transformimng growth factor (TGFβ), interleukin-17 (IL-17), and the serum chemerin levels were determined by enzyme-linked immunosorbent assay. Pearson correlation analysis was conducted to analyze the correlation between serum chemerin and CD4+ T cell subsets, serum cytokine expression. Multivariate logistic regression was used to analyze the influencing factors of patients with autoimmune hepatitis. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of chemerin expression in serum for AIH.Results The levels of serum chemerin in the control group, ALD group and AIH group were (73.88 ± 21.69) mmHg, (89.57 ± 23.58) mmHg and (122.69 ± 31.86)mmHg, respectively, and the difference was statistically significant (P < 0.05). Compared with the control group, IFN -γ, IL-17 and chemorin in the serum of ALD group and AIH group were significantly higher (P < 0.05), and the proportion of Th2 and Treg cells was significantly lower (P < 0.05); compared with ALD group, IFN -γ, IL-17 and chemorin in the serum of AIH group were significantly higher (P < 0.05), and the proportion of Th2 and Treg cells was significantly lower (P < 0.05). Pearson analysis showed that there were positive correlations between chemerin and expressions of Th1, Th17, IFN-γ, IL-17 cells and cytokines (P < 0.05), and negative correlations between chemerin and expressions of Th2 and Treg cells (P < 0.05). Multivariate logistic regression analysis showed that Th1, Th2, Treg, Th17, IFN-γ, IL-17 and fat factor chemerin were independent risk factors for AIH (P < 0.05). ROC curve analysis showedthat the area under the curve (AUC) of serum chemorin level to the diagnosis value of AIH was 0.857 (95% CI: 0.792-0.921), the cutoff value was 94.15 mmHg, the sensitivity and specificity were 80.9% and 88.4%, respectively; the AUC of serum chemorin level to the diagnosis value of AIH was 0.703 (95% CI: 0.614-0.793) with ALD group as the reference. The sensitivity and specificity were 57.4% and 81.2%, respectively.Conclusion Elevated serum chemerin level is an independent risk factor for AIH, which may be a better auxiliary diagnostic index for AIH. |
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