肝硬化患者血清YKL-40水平变化及临床意义

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摘要目的研究肝硬化患者血清YKL-40水平变化与临床特征的关系，初步探讨其临床意义。方法选取2016年2月—2018年12月中国人民解放军联勤保障部队第九八一医院诊治的90例肝硬化患者（肝硬化组）及40例健康查体者（对照组）。应用酶联免疫吸附试验检测两组血清YKL-40水平。分析肝硬化患者的血清YKL-40水平与临床特征之间的关系，Pearson线性相关分析肝硬化患者血清YKL-40水平与肝功能指标[血清总胆红素（TBil）、谷丙转氨酶（ALT）、天冬氨酸转氨酶（AST）、白蛋白（Alb）及凝血酶原时间（PT）]之间的相关性。结果肝硬化组TBil、ALT、AST、血清YKL-40水平及PT明显高于对照组，而Alb水平明显低于对照组（均P ＜ 0.05）。肝硬化组不同年龄、性别、肝硬化原因的血清YKL-40表达水平比较，差异均无统计学意义（均P ＞ 0.05），不同Child-Pugh分级、不同肝纤维化程度、有无并发症的血清YKL-40表达水平比较，差异均有统计学意义（均P ＜ 0.05）。肝硬化组血清YKL-40表达水平与血清TBil、PT、ALT、AST呈正相关（r = 0.532、0.459、0.572、0.622，均P ＜ 0.05），而与血清Alb呈显著负相关（r = -0.513，P ＜ 0.05）。结论肝硬化患者血清中YKL-40水平升高，并与患者肝功能Child-Pugh分级、肝纤维化程度、并发症及肝功能指标有关，有望成为新的肝硬化诊断及判断疾病严重程度的指标。

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	刘丽波1 段旭峰１孔学哲１张保茹１王淑辉１李慧１杨婷1 冯军２

关键词 ：肝硬化, 血清, YKL-40, 天冬氨酸转氨酶

Abstract：Objective To study the relationship between changes in serum YKL-40 levels and clinical characteristics in patients with liver cirrhosis, and to discuss its clinical significance. Methods From February 2016 to December 2018, 90 patients with liver cirrhosis (the liver cirrhosis group) and 40 patients with physical examination (the control group) diagnosed and treated in the No.981 Hospital of the Joint Support Force of the Chinese People’s Liberation Army were selected. The level of serum YKL-40 of the two groups was detected by enzyme linked immunosorbent assay (ELISA).The relationship between YKL-40 levels and clinical characteristics were analyzed. The correlation between serum YKL-40 levels and liver function indicators [total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (Alb), and prothrombin time (PT)] in patients with liver cirrhosis were analyzed by Pearson linear correlation analysis. Results The TBil, ALT, AST, serum YKL-40 levels and PT in the liver cirrhosis group were significantly higher than those in the control group, with Alb level significantly lower than that in the control group (all P ＜ 0.05). There were no statistically significant differences in serum YKL-40 expression levels in the liver cirrhosis group with different age, gender and cirrhosis causes (all P > 0.05), while there were statistically significant differences in serum YKL-40 expression levels in the liver cirrhosis group with different Child-Pugh grades, different degrees of liver fibrosis, and complications or not (all P < 0.05). The expression levels of serum YKL-40 in liver cirrhosis group was positively correlated with serum TBil, PT, ALT and AST (r = 0.532, 0.459, 0.572, 0.622, all P ＜ 0.05), and significantly negatively correlated with serum Alb (r = -0.513, P ＜ 0.05). Conclusion The level of YKL-40 in the serum of patients with liver cirrhosis is increased, and is related to Child-Pugh classification of liver function, liver fibrosis and complications and liver function indexes. It is expected to become a new indicator of liver cirrhosis diagnosis and judgment of disease severity.

Key words： Liver cirrhosis Serum YKL-40 Aspartate aminotransferase

基金资助:河北省省级科技计划自筹经费项目（172777124）。

作者简介: 刘丽波（1970.4-），女，硕士，主任医师；研究方向：消化疾病。

引用本文:

刘丽波1 段旭峰１孔学哲１张保茹１王淑辉１李慧１杨婷1 冯军２. 肝硬化患者血清YKL-40水平变化及临床意义[J]. 中国医药导报, 2020, 17(34): 119-122.
LIU Libo1 DUAN Xufeng1 KONG Xuezhe1 ZHANG Baoru1 WANG Shuhui1 LI Hui1 YANG Ting1 FENG Jun2. Changes and clinical significance of serum YKL-40 levels in patients with liver cirrhosis. 中国医药导报, 2020, 17(34): 119-122.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I34/119

[1] Tsochatzis EA，Bosch J，Burroughs AK. Liver cirrhosis [J]. Lancet，2014，383（9930）：1749-1761.
[2] 张飞，张志勇.763例肝硬化患者的病因及临床特点分析[J].临床消化病杂志，2019，31（2）：89-92.
[3] Romanelli RG，Stasi C. Recent Advancements in Diagnosis and Therapy of Liver Cirrhosis [J]. Curr Drug Targets，2016，17（15）：1804-1817.
[4] 梅琳琳，王雅莉，李红娟，等.YKL-40在卵巢癌细胞生长中的作用[J].实验与检验医学，2019，37（6）：1038-1041.
[5] 杨春花，郑红英，杨金梅.YKL-40在支气管哮喘患者血清中的表达及意义[J].现代诊断与治疗，2018，29（1）：61-63.
[6] El-Asrar MA，Elbarbary NS，Ismail EA，et al. Serum YKL-40 in young patients withβ-thalassemia major：Relation to hepatitis C virus infection，liver stiffness by transient elastography and cardiovascular complications [J]. Blood Cells Mol Dis，2016，56（1）：1-8.
[7] Yan L，Deng Y，Zhou J，et al. China HepB-Related Fibrosis Assessment Research Group.Serum YKL-40 as a biomarker for liver fibrosis in chronic hepatitis B patients with normal and mildly elevated ALT [J]. Infection，2018， 46（3）：385-393.
[8] 王贵强，王福生，成军，等.慢性乙型肝炎防治指南（2015年版）[J].中华实验和临床感染病杂志：电子版，2015，9（5）：570-589.
[9] Flamm SL. Complications of Cirrhosis in Primary Care：Recognition and Management of Hepatic Encephalopathy [J]. Am J Med Sci，2018，356（3）：296-303.
[10] 徐小元，丁惠国，李文刚，等.肝硬化腹水及相关并发症的诊疗指南[J].传染病信息，2017，30（5）：237-253.
[11] Romanelli RG，Stasi C. Recent Advancements in Diagnosis and Therapy of Liver Cirrhosis [J]. Curr Drug Targets，2016，17（15）：1804-1817.
[12] 雒夏，魏雅琪，海龙，等.肝癌血清标志物α-烯醇化酶在肝癌诊断中的初步研究[J].中华肝脏病杂志，2019， 27（7）：505-510.
[13] 沈科书，孙海英，孙颖.甲胎蛋白阴性的肝癌血清标志物筛查及临床意义[J].智慧健康，2018，4（32）：3-4.
[14] Baldacci F，Lista S，Palermo G，et al. The neuroinflammatory biomarker YKL-40 for neurodegenerative diseases：advances in development [J]. Expert Rev Proteomics，2019，16（7）：593-600.
[15] Mushtaq S，Ghani E，Azam K，et al. Comparison of chitinase-3-like protein 1，aspartate aminotransferase-to-platelet ratio index，and fibrosis-4 index with shear-wave elastography [J]. Eur J Gastroenterol Hepatol，2019，31（3）：357-362.
[16] Sun Y，Kong X，Wu S，et al. YKL-40 as a new biomarker of disease activity in Takayasu arteritis [J]. Int J Cardiol，2019，293（3）：231-237.
[17] Lin B，Ma Y，Wu S，et al. Novel Serum Biomarkers for Noninvasive Diagnosis and Screening of Nonalcoholic Fatty Liver Disease-Related Hepatic Fibrosis [J]. OMICS， 2019，23（4）：181-189.
[18] Johansen JS，Christoffersen P，M?覬ller S，et al. Serum YKL-40 is increased in patients with hepatic fibrosis [J]. J Hepatol，2000，32（6）：911-920.
[19] Karalilova R，Kazakova M，Sapundzhieva T，et al. Serum YKL-40 and IL-6 levels correlate with ultrasound findings of articular and periarticular involvement in patients with systemic sclerosis [J]. Rheumatol Int，2019，39（11）：1841-1848.
[20] Fontana RJ，Dienstag JL，Bonkovsky HL，et al. Serum fibrosis markers are associated with liver disease progression in non-responder patients with chronic hepatitis C [J]. Gut，2010，59（10）：1401-1409.
[21] 阮建文，郑琳麟，高丽娟，等.慢性乙型肝炎患者血清IFN-γ、TNF-α与HBV DNA关系研究[J].湖北科技学院学报：医学版，2019，33（3）：216-220
[22] Fontana RJ，Bonkovsky HL，Naishadham D，et al. Serum fibrosis marker levels decrease after successful antiviral treatment in chronic hepatitis C patients with advanced fibrosis [J]. Clin Gastroenterol Hepatol，2009，7（2）：219-226.
[23] Zheng M，Cai WM，Zhao JK，et al. Determination of serum levels of YKL-40 and hyaluronic acid in patients with hepatic fibrosis due to schistosomiasis japonica and appraisal of their clinical value [J]. Acta Trop，2005，96（2/3）：148-52.