Clinical Significance Of Serum Protoporphyrin Ⅸ Determination In Patients With Hepatitis B Cirrhosis

Objective This study aims to evaluate the clinical significance of serum protoporphyrin Ⅸ in the liver function and antiviral efficacy in patients with Hepatitis B cirrhosis and healthy people respectively.Methods Fifty one patients with Hepatitis B cirrhosis and forty healthy people were recruited to test their serum protoporphyrin Ⅸ level by HPLC.Results1.There is statistically significant different between cirrhosis patients[66.51(49.26,90.52)ng/dl] and healthy people [15.43(10.87,20.16)ng/dl](P<0.05)before their treatment.2.The PPⅨ levels of Child-Pugh A,B and C in patients with cirrhosis were 42.45(25.75,63.28)(n=124),90.52(69.99,100.57)(n=21),73.54(64.59,156.47)(n=8)ng/dl.Compared with the control group,Child-Pugh A,B and C grades had statistically significant differences(P<0.05);Child-Pugh A was significantly with grades B and C(P<0.05);There was no statistically significant difference between Child-Pugh B and C grades(P>0.05).3.In order to figure out the diagnostic efficacy of PPⅨ and laboratory indexes,we use the ROC curve to evaluate liver cirrhosis Child-Pugh score.We make the seven as the discipline to divide those patients into two different groups.The area under the curve(AUC)of PPⅨ in group(>7)is 0.853(P<0.05),the critical value is 62.05ng/dl,the sensitivity is 86.2%,the specificity is 75%,and the 95% confidence interval is 0.781-0.952;The AUC of TBIL is 0.869(P<0.05),the critical value is 29.99ng/dl,the sensitivity is 75.9%,the specificity is 91.1%,and the 95% confidence interval is 0.775-0.962;The AUC of AST is 0.800(P<0.05),the critical value is 39.85ng/dl,the sensitivity is 75.9%,the specificity is 21.8%,and the 95% confidence interval is 0.710-0.891;The AUC of ALT is 0.675(P<0.05),the critical value is 40.9U/L,the sensitivity is 65.5%,the specificity is 31.5%,and the 95% confidence interval is 0.567-0.783.PPⅨ has higher sensitivity and lower specificity than TBIL in Child-Pugh score.4.The patients with cirrhosis were given Child-Pugh score,APRI score,FIB-4 score before and after treatment,and correlation analysis was performed.We arrive at some conclusions that: 1)PPⅨ was significantly correlated with Child-Pugh score,APRI score,FIB-4 score,TBIL,AST,ALT,ALB,PLT,and PT(P<0.05),but not with HBV-DNA,ALP,and GGT(P >0.05).2)PPⅨ was moderately positively correlated with Child-Pugh score and TBIL,and moderately negatively correlated with ALB,with rs values of 0.497,0.453,and-0.429 respectively.5.The patients with cirrhosis received standard-dose entecavir antiviral therapy,and the serum PPⅨ and TBIL showed a time-dependent decrease(P<0.05).The differences of HBV-DNA,AST,ALT,ALB,PT were statistically significant before and after treatment(P<0.05),PLT,ALP,GGT had no statistically significant difference before and after treatment(P>0.05).Conclusion Serum protoporphyrin Ⅸ is a kind of great clinical medicine for its good evaluation and early warning function among hepatitis B cirrhosis patients with liver function damage,which means that it can be used as an evaluation factor in antiviral efficacy.