本文選題：血清sP-selectin　切入點(diǎn)：sICAM-　出處：《中國(guó)免疫學(xué)雜志》2017年11期 　論文類(lèi)型：期刊論文

【摘要】：目的:旨在探討血清sP-selectin、sICAM-1和免疫球蛋白檢測(cè)對(duì)乙肝肝硬化預(yù)后評(píng)估的意義。方法:選取池州市人民醫(yī)院于2014年1月~2016年12月收治的162例乙肝肝硬化患者作為研究對(duì)象,分別測(cè)定患者血清可溶性P-選擇素(sP-selectin)、可溶性細(xì)胞間黏附分子-1(sICAM-1)、免疫球蛋白和相關(guān)血清指標(biāo)。比較不同肝硬化患者和肝癌患者血清指標(biāo)差異性,Pearson分析血清可溶性P-選擇素(sP-selectin)、可溶性細(xì)胞間黏附分子-1(sICAM-1)、免疫球蛋白和相關(guān)血清指標(biāo)相關(guān)性,logistic多因素回歸分析肝硬化轉(zhuǎn)肝癌危險(xiǎn)因素,受試者工作特征(ROC)曲線評(píng)價(jià)OR1參數(shù)對(duì)肝硬化轉(zhuǎn)肝癌預(yù)測(cè)價(jià)值。結(jié)果:原發(fā)性肝癌患者sP-selectin、sICAM-1、IgM、IgG、IgA顯著高于代償期肝硬化和失代償期肝硬化患者(P0.05)。失代償期肝硬化患者sP-selectin、sICAM-1、IgM、IgG、IgA顯著高于代償期肝硬化患者(P0.05)。不同Child-Pugh分級(jí)肝硬化患者中,C級(jí)患者sP-selectin、sICAM-1、IgM、IgG、IgA顯著高于B級(jí)和A級(jí)患者(P0.05)。B級(jí)患者sP-selectin、sICAM-1、IgM、IgG、IgA顯著高于A級(jí)患者(P0.05)。多發(fā)癌灶患者和單發(fā)癌灶原發(fā)性肝癌患者sP-selectin、sICAM-1和免疫球蛋白表達(dá)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。Ⅱ期原發(fā)性肝癌患者sP-selectin、sICAM-1和免疫球蛋白顯著高于Ⅰ期患者(P0.05)。肝硬化患者sP-selectin、sICAM-1、免疫球蛋白之間均互為正相關(guān)性(P0.05)。以肝硬化是否轉(zhuǎn)原發(fā)性肝癌為因變量進(jìn)行多因素Logistic回歸分析,結(jié)果顯示,ALT、AST、sP-selectin、sICAM-1、IgM、IgG、IgA均是肝硬化轉(zhuǎn)原發(fā)性肝癌的危險(xiǎn)因素。ROC曲線分析可得,sICAM-1和sP-selectin診斷肝硬化轉(zhuǎn)肝癌敏感性和特異性均高于其他因素。結(jié)論:血清sP-selectin、sICAM-1對(duì)乙肝肝硬化預(yù)后評(píng)估具有較高臨床診斷精度,對(duì)肝硬化轉(zhuǎn)原發(fā)性肝癌的診斷特異度、敏感度高于單純免疫球蛋白檢測(cè),故其聯(lián)合檢測(cè)診斷肝硬化預(yù)后值得臨床推廣。
[Abstract]:Objective: to investigate the significance of serum sP-selectinus sICAM-1 and immunoglobulin in evaluating the prognosis of hepatitis B cirrhosis. Methods: 162 patients with hepatitis B cirrhosis admitted in Chizhou people's Hospital from January 2014 to December 2016 were selected as study subjects. Serum soluble P- selectin, soluble intercellular adhesion molecule-1, immunoglobulin and related serum indexes were measured respectively. The difference of serum levels between different liver cirrhosis patients and liver cancer patients was compared. Pearson analysis of serum soluble P-. SP-selectinus, soluble intercellular adhesion molecule-1 (sICAM-1), immunoglobulin and related serum markers were correlated with logistic multivariate regression analysis for the risk factors of liver cirrhosis to liver cancer. Results: the sP-selectinus sICAM-1 IgMM-1 IgGG OR1 in patients with primary liver cancer was significantly higher than that in patients with compensatory cirrhosis and decompensated cirrhosis (P0.05A). SP-selectinus sICAM-1IgMM-1IgMGG A in patients with decompensated cirrhosis was significantly higher than that in patients with compensatory cirrhosis and decompensated cirrhosis (P < 0.05). SP-selectinus sICAM-1 IgMN IgGA in patients with different Child-Pugh grade cirrhosis was significantly higher than that in patients with grade B and grade A (P0.05) and sP-selectinine sICAM-1 IgMG IgA was significantly higher than that in grade A patients with multiple carcinomas and primary hepatocellular carcinoma (P0.05). The expression of sP-selectinus sICAM-1 and immunoglobulin in patients with stage 鈪，

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