【摘要】 目的比较壳多糖酶3样蛋白1(chitinase-3-like protein 1,CHI3L1)、γ-谷氨酰转肽酶和血小板比值指数(γ-glutamyl transpeptidase platelet ratio index,GPR)对肝纤维化患者的诊断效能。方法回顾性选择2019年1月—2020年6月本院收治的拟诊为肝纤维化患者524例,所有患者均经肝穿刺活检确诊412例,所有患者均检测CHI3L1和GPR水平,并与肝穿刺活检结果比较。结果不同分期肝纤维化CHI3L1和GPR水平比较,随着肝纤维化严重程度增加而增加(P <0.05)。CHI3L1检查肝纤维化患者与活体穿刺结果准确率为96.84%,Kappa=0.76,提示CHI3L1检查与活体穿刺结果有较高的一致性;GPR检查与活体穿刺准确率为52.91%,Kappa=0.48,提示GPR检查肝纤维化患者与肝活体穿刺结果的一致性一般。CHI3L1诊断肝纤维化的AUC为0.939,灵敏度为89.83%,特异度为77.75%;GPR诊断肝纤维化的AUC为0.829,灵敏度为79.66%,特异度为79.77%。CHI3L1检验肝纤维化的AUC高于GPR检验肝纤维化的AUC。结论 CHI3L1较GPR更利于作为肝纤维化的诊断及不同分期肝纤维化的标记物,因其不同分期表达水平不同,其也可作为动态观察肝纤维化进展的检测标记物。更多还原

【Abstract】 Objective To compare the diagnostic efficacy of CHI3 L1 and GPR in patients with liver fibrosis. Methods From January 2019 to June 2020, 412 patients with liver fibrosis in our hospital were selected. The levels of CHI3 L1 and GPR were detected in all patients, and the results were compared with those of liver biopsy. Results The levels of CHI3 L1 and GPR in different stages of liver fibrosis increased with the severity of liver fibrosis(P < 0.05). The accuracy rate of CHI3 L1 and biopsy was 96.84%, Kappa =0.76, which indicated that CHI3 L1 and biopsy had high consistency; the accuracy rate of GPR and biopsy was 52.91%,Kappa=0.48, which indicated that GPR and biopsy had general consistency.The AUC of CHI3 L1 was 0.939, sensitivity 89.83%, specificity 77.75%;the AUC of GPR was 0.829, sensitivity 79.66%, specificity 79.77%. The AUC of CHI3 L1 was higher than that of GPR. Conclusion Compared with GPR, CHI3 L1 can be used as a marker for the diagnosis of liver fibrosis and different stages of liver fibrosis. Because of its different expression levels in different stages, CHI3 L1 can also be used as a detection marker for dynamic observation of the progress of liver fibrosis.更多还原