血清铜蓝蛋白可预测乙肝病毒感染患者的肝纤维化

StephenW

Serum ceruloplasmin can predict liver fibrosis in hepatitis B virus-infected patients
Na-Ling Kang  1 , Jie-Min Zhang  2 , Meng-Xin Lin  3 , Xu-Dong Chen  4 , Zu-Xiong Huang  5 , Yue-Yong Zhu  1 , Yu-Rui Liu  1 , Da-Wu Zeng  6
Affiliations
Affiliations

    1
    Liver Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China.
    2
    Department of Pharmacy, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China.
    3
    Department of Infectious Diseases, The First Hospital of Quanzhou Affiliated with Fujian Medical University, Quanzhou 362000, Fujian Province, China.
    4
    Department of Gastroenterology, the 910th Hospital of the People's Liberation Army, Quanzhou 362000, Fujian Province, China.
    5
    Hepatology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China.
    6
    Liver Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China. [email protected].

    PMID: 32774069 PMCID: PMC7385565 DOI: 10.3748/wjg.v26.i27.3952

Abstract

Background: The presence of significant liver fibrosis in hepatitis B virus (HBV)-infected individuals with persistently normal serum alanine aminotransferase (PNALT) levels is a strong indicator for initiating antiviral therapy. Serum ceruloplasmin (CP) is negatively correlated with liver fibrosis in HBV-infected individuals.

Aim: To examine the potential value of serum CP and develop a noninvasive index including CP to assess significant fibrosis among HBV-infected individuals with PNALT.

Methods: Two hundred and seventy-five HBV-infected individuals with PNALT were retrospectively evaluated. The association between CP and fibrotic stages was statistically analyzed. A predictive index including CP [Ceruloplasmin hepatitis B virus (CPHBV)] was constructed to predict significant fibrosis and compared to previously reported models.

Results: Serum CP had an inverse correlation with liver fibrosis (r = -0.600). Using CP, the areas under the curves (AUCs) to predict significant fibrosis, advanced fibrosis, and cirrhosis were 0.774, 0.812, and 0.853, respectively. The CPHBV model was developed using CP, platelets (PLT), and HBsAg levels to predict significant fibrosis. The AUCs of this model to predict significant fibrosis, advanced fibrosis, and cirrhosis were 0.842, 0.920, and 0.904, respectively. CPHBV was superior to previous models like the aspartate aminotransferase (AST)-to-PLT ratio index, Fibrosis-4 score, gamma-glutamyl transpeptidase-to-PLT ratio, Forn's score, and S-index in predicting significant fibrosis in HBV-infected individuals with PNALT.

Conclusion: CPHBV could accurately predict liver fibrosis in HBV-infected individuals with PNALT. Therefore, CPHBV can be a valuable tool for antiviral treatment decisions.

Keywords: Ceruloplasmin; Chronic hepatitis B infection; Liver fibrosis; Noninvasive model; Receiver-operating characteristic; Serum alanine aminotransferase.

©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.

StephenW

血清铜蓝蛋白可预测乙肝病毒感染患者的肝纤维化
康娜玲1，张杰敏2，林孟新3，陈旭东4，黄祖雄5，朱跃勇1，刘玉瑞1，曾大武6
隶属关系
隶属关系

    1个
    福建医科大学附属第一医院肝病中心，福建福州350005。
    2
    福建医科大学附属第一医院药剂科，福建福州350005。
    3
    福建医科大学附属泉州第一医院感染科，福建泉州362000。
    4
    解放军第910医院消化内科，福建泉州362000
    5
    福建医科大学蒙潮肝胆医院肝病科，福建福州350005
    6
    福建医科大学附属第一医院肝病中心，福建福州350005。 [email protected]。

    PMID：32774069 PMCID：PMC7385565 DOI：10.3748 / wjg.v26.i27.3952

抽象

背景：血清丙氨酸氨基转移酶（PNALT）水平持续正常的乙肝病毒（HBV）感染个体中存在明显的肝纤维化，是开始抗病毒治疗的重要指标。血清铜蓝蛋白（CP）与HBV感染者的肝纤维化呈负相关。

目的：检查血清CP的潜在价值，并开发包括CP在内的非侵入性指标，以评估HBALT感染的PNALT患者中明显的纤维化。

方法：回顾性分析275例感染了PNALT的HBV感染者。对CP和纤维化阶段之间的关联进行统计分析。构建了包括CP [铜蓝蛋白乙型肝炎病毒（CPHBV）]的预测指标来预测明显的纤维化，并与先前报道的模型进行了比较。

结果：血清CP与肝纤维化呈负相关（r = -0.600）。使用CP，预测严重纤维化，晚期纤维化和肝硬化的曲线下面积（AUC）分别为0.774、0.812和0.853。使用CP，血小板（PLT）和HBsAg水平开发CPHBV模型，以预测明显的纤维化。可以预测严重纤维化，晚期纤维化和肝硬化的模型的AUC分别为0.842、0.920和0.904。 CPHBV在预测HBV感染的显着纤维化方面优于天冬氨酸转氨酶（AST）与PLT比率指数，Fibrosis-4得分，γ-谷氨酰转肽酶与PLT比率，Forn得分和S指数等先前模型。 PNALT的个体。

结论：CPHBV可以准确预测PNALT的HBV感染者的肝纤维化。因此，CPHBV可能是决定抗病毒治疗的有价值的工具。

关键字：铜蓝蛋白慢性乙型肝炎感染；肝纤维化；无创模型接收机工作特性；血清丙氨酸氨基转移酶。

©2020年作者。百事登出版集团有限公司出版。保留所有权利。

StephenW

https://www.wjgnet.com/1007-9327/full/v26/i27/3952.htm