文章摘要
杨美 郭晓东 郭超楠 刘元 朱莉 赵景民.血清IL-1RA水平与非酒精性脂肪性肝病的相关性及无创诊断的临床价值[J].,2014,14(28):5520-5524
血清IL-1RA水平与非酒精性脂肪性肝病的相关性及无创诊断的临床价值
Study of SerumLevel of IL-1RA Level with Non-alcoholic FattyLiver Disease and the Non-invasive Diagnostic
  
DOI:
中文关键词: IL-1Ra  NASH  无创诊断
英文关键词: IL-1RA  NASH  Non-invasive diagnostic
基金项目:中国肝炎防治基金会王宝恩肝纤维化研究基金(CFHPC20131020)
作者单位
杨美 郭晓东 郭超楠 刘元 朱莉 赵景民 解放军第302 医院 
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中文摘要:
      目的:探究血清白介素-1 受体拮抗剂(IL-1RA)与非酒精性脂肪性肝病(NAFLD)进展的相关性,以及无创性预测诊断 NASH 的临床价值。方法:选取确诊NAFLD 病例60 例,配套肝穿刺活检组织标本及肝穿前一周血清。经B 超检查无脂肪肝症状 的正常健康人群30 例,作为对照。测量身高、体重、腰围等生理指标,计算BMI;检测ALT、AST、AST/ALT、ALP、GGT、TC、TG、 HDL、LDL 等生化指标;双抗夹心法测定血清中IL-1RA 浓度水平。结果:血清IL-1RA与ALT、AST 及GGT具有相关性(P < 0.05) ,与肝细胞脂肪变性、气球样变、小叶内炎症、汇管区炎症及纤维化程度呈高度相关(P < 0.01);随NAS 评分增高其浓度增 大,呈高度正相关(r = 0.915,P < 0.01);NASH 患者血清中IL-1RA 明显高于Non-NASH 患者( t = 2.88,P < 0.01),经ROC 曲线分 析,曲线下面积AUROC = 0.986,利用Youden 指数确定最佳敏感性为89.7%,特异性为97.9%,最佳cut-off 值为171.8 ng/L。结 论:NASH患者血清IL-1RA 水平明显升高,血清IL-1RA可作为评价NASH 及其严重程度的独立预测因子,可以作为一个无创性 诊断指标对NASH 进行诊断
英文摘要:
      Objective:To research the correlation between IL-1RA in serum and the progression of NAFLD, and to discuss the clinical significance of non-invasively diagnosis.Methods:60 cases with the NAFLD who were confirmed by the liver biopsy tissue samples and serum were selected as the study group, and another 30 cases who were examined no fatty liver symptoms by B-ultrasound were chosen to be the controls. Then the height, weight, waist circumference and other physiological indicators were measured, the BMI was calculated, the ALT, AST, AST/ALT, ALP, GGT, TC, TG, HDL, LDL and other biochemical markers were detected; dual-antibody sandwich ELISA was used to determine the concentration level of serum IL-1RA.Results:Serum levels of IL-1RA is associated with ALT, AST and GGT(P<0.05); hepatic steatosis, ballooning degeneration, lobular inflammation, periportal inflammation and fibrosis were highly correlated (P<0.01); the correlation was high when the NAS rating increased its concentrations(r=0.915, P<0.01); serum levels of IL-1RA in NASH patients was significantly higher than that of the Non-NASH patients (t=2.88, P<0.01); ROC curve analysis area under the curve AUROC=0.986, the optimum sensitivity was 89.7% determined by Youden index, and the specificity was 97.9%, the best cut-off value of 171.8 ng/L.Conclusion:Patients with NASH serum levels of IL-1RA were significantly increased. Serum levels of IL-1RA can be used as an independent predictor to evaluate NASH, and used as a non-invasive diag levels of nostic indicators to diagnose NASH.
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