胆石症患者血清微小RNA -122、高迁移率族蛋白1和角蛋白-18水平及其临床意义*

doi:10.3969/j.issn.1672-5069.2019.02.033

实用肝脏病杂志 ›› 2019, Vol. 22 ›› Issue (2): 285-288.doi: 10.3969/j.issn.1672-5069.2019.02.033

胆石症患者血清微小RNA -122、高迁移率族蛋白1和角蛋白-18水平及其临床意义^*

程铁军,张明智

113008 辽宁省抚顺市抚顺矿务局总医院干部二病房（程铁军）;
锦州医科大学附属第三医院消化科（张明智）

收稿日期:2018-11-28 出版日期:2019-03-10 发布日期:2019-03-19
作者简介:程铁军,男,50岁,大学本科,副主任医师。E-mai:chengtiejun987@sina.com
基金资助:
*辽宁省科学技术研究计划项目（编号：2012225084）

Serum levels of microRNA-122,high mobility group protein 1 and caspase-cleaved keratin-18 in patients with cholelithiasis and their clinical significance

Cheng Tiejun, Zhang Mingzhi

Cadre Ward,General Hospital,Mining Bureau,Fu Shun 113008,Liaoning Province,China

Received:2018-11-28 Online:2019-03-10 Published:2019-03-19

摘要/Abstract

摘要： 目的探讨胆石症患者血清微小RNA -122（miR-122）、高迁移率族蛋白1（HMGB 1）和半胱氨酸天冬氨酸蛋白酶裂解角蛋白-18（CCK-18）水平变化及其临床意义。方法 2015年1月~2018年2月我院收治的201例胆石症患者和健康体检者103例,比较两组人群血清miR-122、HMGB 1和CCK-18水平差异。采用Logistic回归分析影响单纯性胆石症进展为复杂性胆石症的相关因素。采用受试者工作特征曲线（ROC）下面积（AUC）分析血清指标诊断复杂性胆石症的效能。结果胆石症患者血清miR-122、HMGB 1和CCK-18水平分别为4.7（0.9,14.3）、（2.5±0.7） ng/mL和（126.8±20.5）U/L,显著高于健康人【0.9（0.4,3.1）、（2.1±0.4） ng/mL和（101.4±18.7） U/L,均P<0.05】;97例单纯性胆石症组血清miR-122、HMGB 1和CCK-18分别为3.5（0.7,8.5）、（2.2±0.5）ng/mL和（112.4±19.4）U/L,显著低于104例复杂性胆石症组【分别为5.8（0.9,16.2）、（2.8±0.8） ng/mL和（140.2±23.5） U/L,均P<0.05】;单因素和多因素Logistic回归分析显示,肝硬化、腹腔积液、血清miR-122、HMGB 1和CCK-18为单纯性胆石症进展为复杂性胆石症的危险因素;血清miR-122、HMGB 1和CCK-18水平三者联合检测诊断复杂性胆石症的AUC为0.819（0.758~0.962）,显著高于miR-122【0.724（0.657~0.815）】、HMGB 1【0.701（0.633~0.804）或CCK-18【0.767（0.702~0.873）】单指标检测。结论对血清miR-122、HMGB 1和CCK-18水平升高的胆石症患者,应想到复杂性胆石症的可能,而给予更仔细的检查和特别处理。

关键词: 胆石症, 复杂性胆石症, 微小RNA-122, 高迁移率族蛋白1, 半胱氨酸天冬氨酸蛋白酶裂解角蛋-18

Abstract: Objects To investigate serum microRNA-122（miR-122）,high mobility group protein 1 （HMGB1） and caspase-aspartate proteolytic keratin-18 （CCK-18） level changes in patients with cholelithiasis and their clinical significance. Methods 201 patients with cholelithiasis and 103 healthy persons admitted to our hospital between January 2015 and February 2018 were enrolled,and serum miR-122,HMGB1 and CCK-18 levels were compared between the two groups. Logistic regression analysis was applied to analyze the risk factors affecting the progression of simple cholelithiasis into complex cholelithiasis. The efficacy of serum markers in the diagnosis of complex cholelithiasis was analyzed by area under the receiver operating characteristic curve （AUC）. Results Serum levels of miR-122,HMGB1 and CCK-18 in patients with cholelithiasis were 4.7（0.9,14.3）,（2.5±0.7） ng/mL and（126.8±20.5） U/L,respectively,significantly higher than[0.9 （0.4,3.1）,（2.1±0.4） ng/mL and （101.4±18.7） U/L,all P<0.05] in control;serum miR-122,HMGB1 and CCK-18 in 97 patients with simple cholelithiasis were 3.5（0.7,8.5）,（2.2±0.5） ng/mL and （112.4±19.4） U/L,respectively,significantly lower than in 104 patients with complex cholelithiasis [5.8 （0.9,16.2）,（2.8±0.8） ng/mL and （140.2±23.5） U/L,respectively,P<0.05];univariate and multivariate Logistic regression analysis showed that liver cirrhosis,peritoneal effusion,serum miR-122,HMGB1 and CCK-18 were the risk factors related to simple cholelithiasis turned to complex one;our findings also showed that the combination of the three serum parameters increased the diagnostic efficacy of complex cholelithiasis[AUC 0.819（0.758~0.962） vs. AUC miR-122 0.724（0.657~0.815）,AUC HMGB 1 0.701（0.633~0.804） or AUC CCK-18 0.767（0.702~0.873）]. Conclusion The patients with cholelithiasis and high serum mir-122,HMGB1 and CCK-18 levels might be sophisticated in disease severity,and should be taken into consideration and carefully managed.

Key words: Cholelithiasis, Complex cholelithiasis, MicroRNA-122, High mobility group protein 1, Cysteine aspartate protease cleavage keratin-18

程铁军,张明智. 胆石症患者血清微小RNA -122、高迁移率族蛋白1和角蛋白-18水平及其临床意义^*[J]. 实用肝脏病杂志, 2019, 22(2): 285-288.

Cheng Tiejun, Zhang Mingzhi. Serum levels of microRNA-122,high mobility group protein 1 and caspase-cleaved keratin-18 in patients with cholelithiasis and their clinical significance[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(2): 285-288.

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胆石症患者血清微小RNA -122、高迁移率族蛋白1和角蛋白-18水平及其临床意义^*

Serum levels of microRNA-122,high mobility group protein 1 and caspase-cleaved keratin-18 in patients with cholelithiasis and their clinical significance

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