文章摘要
HBV-ACLF患者血清miR-122和 HMGB1水平及其与病情、预后的关系
Serum levels of miR-122 and HMGB1 andtheir relationship with disease condition and prognosis in patients with HBV-ACLF polysaccharides on Hep G2.215 cells and its mechanism
  
DOI:10.3969/j.issn.1007-8134.2022.02.007
中文关键词: HBV  慢加急性肝衰竭  miR-122  高迁移率族蛋白1  病情  预后
英文关键词: HBV  acute-on-chronic liver failure  miR-122  high-mobility group box-B1  disease condition  prognosis
基金项目:国家自然科学基金青年基金(81702019,82002158);国家自然科学基金面上项目(82072298)
作者单位
陈科第 襄阳市中医医院肝胆科 
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中文摘要:
      [摘要] 目的 探究HBV相关慢加急性肝衰竭(HBV-related acute-on-chronic liver failure, HBV-ACLF)患者血清中微小核糖核酸(microRNA, miR)-122和高迁移率族蛋白1(high-mobility group box-B1, HMGB1)水平及其与病情、预后的关系。方法 回顾性分析2016年1月—2018年1月我院收治的120例HBV-ACLF患者的一般及临床资料。根据临床结局,将患者分为存活组(53例)和死亡组(67例)。比较2组患者的一般资料、实验室检查指标及血清miR-122、HMGB1水平。多因素Logistic回归分析影响患者预后的因素。Pearson检验分析miR-122、HMGB1水平分别与TBIL、PA、终末期肝病评分模型(the model of end-stage liver disease score, MELD)评分的相关性。ROC曲线分析miR-122和HMGB1水平对患者的死亡预测价值,获得最佳临界值。根据临界值将患者分为A组、B组和C组,用Kaplan-Meier法绘制生存曲线,比较3组患者在3年随访期间的生存率。结果 存活组和死亡组患者的年龄、身体质量指数、并发症、病情分期、MELD评分、ALB、球蛋白、TBIL、ALT、AST、LDH、PT、PTA、HBV DNA、miR-122、HMGB1相比,差异均具有统计学意义(P均<0.05)。年龄、并发症、病情分期、MELD评分、TBIL、PT、PTA、miR-122、HMGB1均是影响患者预后的危险因素(P均<0.05)。miR-122、HMGB1水平分别与TBIL、MELD评分呈显著正相关,与PTA呈显著负相关(P均<0.05)。miR-122和HMGB1预测患者死亡的最佳临界值分别为31.42和14.56 μg/L。A组患者预后3年内生存率显著高于B组和C组(P均<0.05)。结论 miR-122和HMGB1水平与HBV-ACLF患者的病情和死亡预后密切相关,可间接反映患者的病情严重程度,在HBV-ACLF的诊断及预后中具有重要价值。
英文摘要:
      [Abstract] Objective To explore the serum levels of microRNA-122 (miR-122) and high-mobility group box-B1 (HMGB1) and their relationship with disease condition and prognosis in patients with HBV-related acute-on-chronic liver failure (HBV-ACLF). Methods A retrospective analysis on the general and clinical data of 120 HBV-ACLF patients who were admitted to our hospital from January 2016 to January 2018 was performed. According to the clinical outcome, the patients were divided into survival group (n=53) and death group (n=67). The general data, laboratory test indexes and serum miR-122 and HMGB1 levels of patients in 2 groups were compared. Multivariate Logistic regression analysis of factors affecting the prognosis of patients was carried out. Pearson correlation analysis was performed for the correlation between miR-122, HMGB1 and TBIL, PA, the model of end-stage liver disease score (MELD) score, respectively. ROC curve analysis was performed for the predictive value of miR-122 and HMGB1 on the death of patients and the optimal cut-off value was obtained. According to the cut-off value, the patients were divided into groups A, B and C, and the survival curve was plotted with the Kaplan-Meier method to compare the survival rates of patients in 3 groups during the 3-year follow-up period. Results The differences in age, body mass index, complications, disease stage, MELD score, ALB, GLO, TBIL, ALT, AST, LDH, PT, PTA, HBV DNA, miR-122 and HMGB1 between the survival group and the death group were statistically significant (P<0.05). Age, complications, disease stage, MELD score, TBIL, PT, PTA, miR-122, HMGB1 were all independent factors influencing the prognosis of patients (P<0.05). miR-122 and HMGB1 were significantly positively correlated with TBIL MELD scores, respectively and significantly negatively correlated with PTA (P<0.05). The optimal cut-off values for miR-122 and HMGB1 to predict the patient’s death were 31.42 and 14.56 μg/L, respectively. The survival rate of patients in group A within 3 years was significantly higher than that in groups B and C (P<0.05). Conclusions The levels of miR-122 and HMGB1 are closely related to the disease condition and death of HBV-ACLF patients. They can indirectly reflect the severity of the disease condition of patients and have important value in the diagnosis and prognosis of HBV-ACLF.
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