肝硬化患者血清脂联素、脂多糖、基质金属 蛋白酶-2 水平及其诊断价值

Levels of serum sdiponectin, lipopolysaccharide and matrix metalloproteinase-2 in patients with liver cirrhosis and diagnostic value

摘要:

目的 探讨肝硬化患者血清脂联素（APN）、脂多糖（LPS）、基质金属蛋白酶-2（MMP-2） 水平及其诊断价值。方法 选取2017 年6 月—2019 年6 月沧州市中心医院消化内科诊断为肝硬化的患者 90 例作为观察组。选取同期该院健康体检者30 例作为对照组。分别检测两组血清APN、LPS 及MMP-2 水平，并利用受试者工作特征（ROC）曲线探讨三者对肝硬化的诊断价值。结果 观察组血清APN、LPS 及MMP-2 较对照组高（P <0.05）。Child-Pugh 分级B、C 级患者血清LPS、MMP-2 较A 级高，C 级较 B 级高（P <0.05）。血清APN、LPS 及MMP-2 敏感性分别为75.0%（95% CI ：0.687，0.816）、79.2%（95% CI ：0.728，0.875）和66.7%（95% CI ：0.594，0.734）；特异性分别为47.8%（95%CI ：0.416，0.533）、45.7% （95% CI ：0.409，0.517） 和69.6%（95% CI ：0.651，0.750）；3 项指标联合诊断肝硬化的敏感性为66.7% （95% CI ：0.603，0.742），特异性为97.8%（95% CI ：0.951，0.985）。结论 肝硬化患者血清APN、LPS 及 MMP-2 水平显著升高，且血清APN、LPS 及MMP-2 对肝硬化诊断、治疗及预后有一定价值，三者联合诊 断肝硬化具有更高的临床价值。

Abstract:

Objective To investigate the serum adiponectin (APN), lipopolysaccharide (LPS), matrix metalloproteinase-2 (MMP-2) levels in patients with liver cirrhosis and their diagnostic value. Methods From June 2017 to June 2019, 90 patients with liver cirrhosis diagnosed in the Department of Gastroenterology of Cangzhou central hospital were selected. According to the Child-Pugh classification, the patients were divided into three groups: group A (n = 31), group B (n = 32) and group C (n = 27). At the same time, 30 healthy people were selected as the control group. The levels of serum APN, LPS and MMP-2 in the two groups were measured, and the receiver operating characteristic curve (ROC) was used to explore the diagnostic value of the serum APN, LPS and MMP-2 for liver cirrhosis. Results The levels of serum APN, LPS and MMP-2 in the observation group were significantly higher than those in the control group, and the differences were statistically significant (P < 0.05). The levels of serum LPS and MMP-2 in patients with Child-Pugh B and Child-Pugh C were higher than Child-Pugh A,and the differences were all statistically significant (P < 0.05). The sensitivity of serum APN, LPS and MMP-2 was 75.0% (95% CI: 0.687, 0.816), 79.2% (95% CI: 0.728, 0.875) and 66.7% (95% CI: 0.594, 0.734); the specificity was 47.8% (95% CI: 0.416, 0.533), 45.7% (95% CI: 0.409, 0.517) and 69.6% (95% CI: 0.651, 0.750), respectively. The sensitivity of combined diagnosis of liver cirrhosis was 66.7% (95% CI: 0.603, 0.742), and the specificity was 97.8% (95% CI: 0.951, 0.985). Conclusions The serum levels of APN, LPS and MMP-2 in patients with liver cirrhosis are significantly increased, and the serum APN, LPS, and MMP-2 are valuable in the diagnosis, treatment and prognosis of liver cirrhosis. The combined detection has higher clinical value in the diagnosis of liver cirrhosis.