胎儿素A和胎儿素B作为乙型肝炎肝纤维化的指标

Arzu Şenol, Şafak Özer Balin, Zülal Aşçı Toraman
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摘要

摘要目的探讨胎儿蛋白A和胎儿蛋白B在慢性乙型肝炎(CHB)和乙型肝炎(HBe) ag阴性慢性感染(HCI)中的诊断和预后特点,以及这些蛋白水平与CHB纤维化的关系。方法98例CHB患者,58例HCI患者和42例对照组。ELISA法检测胎儿素A、B水平。结果对照组血清胎儿素A、B水平明显高于乙型肝炎患者(p=0.001)。CHB和HCI患者的胎儿素A和B水平无显著差异。在CHB中,重度纤维化患者的胎儿素A水平明显低于轻度纤维化患者(p=0.007)。重度纤维化患者的胎儿素B低于轻度纤维化患者;然而,这种差异并不显著。在预测无明显纤维化时,使用ROC曲线估计胎儿素A曲线下面积为0.855,胎儿素B曲线下面积为0.866。结论胎儿素A和B在CHB和HCI中的含量低于对照组,两组之间无差异,提示这些蛋白可能在乙型肝炎肝损伤的发病机制中起作用。胎儿蛋白A和B在CHB明显纤维化患者中较低,可作为早期发现纤维化及进展为明显纤维化随访的非侵入性标志物。
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Fetuin A and fetuin B as an indicator of liver fibrosis in hepatitis B
Abstract Objectives The aim of this study is to investigate the diagnostic and prognostic characteristics of fetuin A and fetuin B in chronic hepatitis B(CHB) and HBe Ag-negative chronic infection (HCI) and the relationship between the levels of these proteins and fibrosis in CHB. Methods In this study, we examined 98 patients with CHB, 58 with HCI and 42 control groups. Fetuin A and B levels were determined via ELISA. Results Serum fetuin A and B levels were significantly higher in the control group than the hepatitis B cases (p=0.001). No significant difference in fetuin A and B levels between patients in the CHB and HCI. In the CHB, fetuin A level was significantly lower in patients with significant fibrosis than those with mild fibrosis (p=0.007). Fetuin B was lower in patients with significant fibrosis than in with mild fibrosis; however, this difference was not significant. In predicting the absence of significant fibrosis, the area under the curve was estimated as 0.855 for fetuin A and 0.866 for fetuin B using the ROC curve. Conclusions Fetuin A and B were lower in CHB and HCI compared to the control group and there was no difference between the two groups suggests that these proteins may be effective in the pathogenesis of hepatitis B-induced liver damage. Fetuin A and B, which are found to be lower in patients with significant fibrosis in CHB, can be used as non-invasive markers in the early detection of fibrosis and in the follow-up of progression to significant fibrosis.
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