慢性丙型肝炎外周血miR-1273g-3p水平变化及其诊断肝纤维化分期的效能分析*

doi:10.3969/j.issn.1672-5069.2018.03.021

摘要/Abstract

摘要： 目的探讨检测血清miR-1273g-3p水平诊断慢性丙型肝炎（CHC）患者肝纤维化分期的效能。方法我院诊治的57例CHC患者和同期入选的21例经体检显示为正常的健康人,采用实时荧光定量PCR法检测血清miR-1273g-3p水平。CHC患者接受长效干扰素α2b联合利巴韦林标准疗法治疗12 m,并接受肝穿刺活检行组织病理学检查。结果 13例肝组织呈F0期患者血清miR-1273g-3p相对水平为（1.02±0.3）,20例F1-2期患者为（1.68±0.26）,24例F3-4期患者为（4.21±0.42）,存在肝纤维化的CHC患者血清miR-1273g-3p相对水平显著高于健康人【（1.03±0.2）,P<0.05】;在抗病毒治疗12 m末,CHC F0期、F1-2期和F3-4期患者血清miR-1273g-3p相对水平依次变化为（1.03±0.4）、（1.43±0.22）和（3.97±0.2）,均显著低于治疗前（P<0.05）;在治疗前,分别以血清miR-1273g-3p水平>1.68和血清miR-1273g-3p水平>4.20为截断点诊断存在肝纤维化和显著肝纤维化,其ROC曲线下面积（AUC）分别为0.830,95％CI为0.714~0.973,诊断的灵敏度为72.2％,特异度为86.4％,和0.864,95％CI为0.701~0.976,诊断的灵敏度为83.6％,特异度为78.4％;在治疗后,经肝组织病理学检查发现CHC患者 F0期、F1期、F2期、F3、F4期依次为15例、9例、14例、11例、8例,血清miR-1273g-3p水平诊断存在肝纤维化和显著肝纤维化的效能仍然较好。结论血清miR-1273g-3p水平随着CHC患者肝纤维化进展而逐渐升高,在抗病毒治疗后,随着肝纤维化的缓解而降低,因而具有一定的判断肝纤维化程度的效能,值得进一步研究。

关键词: 慢性丙型肝炎, 肝纤维化, 血清miR-1273g-3p, 诊断

Abstract: Objective T o explore the efficacy of serum miR-1273g-3p levels in diagnosis of liver fibrosis in patients with chronic hepatitis C（CHC）. Methods 57 patients with CHC and 21 healthy persons were recruited in our hospital,and serum miR-1273g-3p were detected by real-time polymerase chain reaction. The patients with CHC received standardized peg-interferon-α2b and ribavirin therapy for 12 months,and received liver biopsies before and after the regimen. Results Serum miR-1273g-3p levels were（1.02±0.3） in 13 CHC patients with liver fibrosis 0（F0）,（1.68±0.26） in 20 with F 1-2,and（4.21±0.42） in 24 with F 3-4,respectively,which suggested serum miR-1273g-3p levels in patients with liver fibrosis were much higher than 【（1.03±0.2）,P<0.05】 in healthy persons or in patients without;at the end of the regimen,serum miR-1273g-3p levels in patients with CHC F0,F1-2 and F3-4 were（1.03±0.4）,（1.43±0.22） and （3.97±0.2）,respectively,much lower than those before anti-viral treatment （P<0.05）;the AUC of serum miR-1273g-3p levels in diagnosing liver fibrosis and significant liver fibrosis were 0.830,95％CI为0.714~0.973 （sensitivity 72.2％ and specificity 86.4％）,and were 0.864,95％CI为0.701~0.976 （sensitivity 83.6％ and specificity 78.4％,as the cut-off-value were >1.68 and >4.20,respectively;at discontinuation of the regimen,the liver histological examination showed that the liver fibrosis was F0 in 15,F1 in 9,F2 in 14,F3 in 11 and F4 in 8. Conclusion s Serum miR-1273g-3p levels might be used to diagnose liver fibrosis in patients with CHC,which warrants further investigation.

Key words: Hepatitis C, miR-1273g-3p, Liver fibrosis, Diagnosis

王婧婧, 张瑜, 董娜, 韩振坤, 翟景明. 慢性丙型肝炎外周血miR-1273g-3p水平变化及其诊断肝纤维化分期的效能分析*[J]. 实用肝脏病杂志, 2018, 21(3): 401-404.

Wang Jingjing, Zhang Yu, Dong Na, et al. Efficacy of serum miR-1273g-3p levels in diagnosis of liver fibrosis in patients with chronic hepatitis C[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(3): 401-404.

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