| Methods: A total of 178 patients with HBV related chronic liver disease who were hospitalized in Affiliated Hospital of Chuanbei Medical College from February 2015 to January 2018 were enrolled in this study.Including 74 cases of chronic hepatitis B,51 cases of liver cirrhosis,53 cases of chronic severe hepatitis.30 healthy people who received the physical examination were set as the control group.The GP73 level was compared.The 53 patients with chronic severe hepatitis were divided into the recovery group and the death group according to the status of the third month of follow-up,and the area under the receiver-operating characteristic(ROC)curve was applied to evaluate the value of serum GP73 predictive value for the prognosis of patients with chronic severe hepatitis.Enzyme-linked immunosorbent assay was used for quantitative detection of serum GP73.The following quantitative tests were completed by our laboratory: ALB,ALT and TBil were detected by birth analyzer,and PTA was detected by automatic coagulation analyzer.All data were statistically analyzed by SPSS 22.0 statistical software.Results: 1.The serum GP73 concentration in healthy control group,chronic hepatitis B group,cirrhosis group and chronic severe hepatitis group was 31.23±16.03ng/ml,132.73±62.10ng/ml,206.78±46.65ng/ml and 254.15±54.51ng/ml,the difference was statistically significant(p<0.01).The expression level of serum GP73 in chronic hepatitis B group,liver cirrhosis group and chronic severe hepatitis group was from high to low to chronic severe hepatitis group > cirrhosis group > chronic hepatitis B group > healthy control group.The difference was statistically significant(P < 0.01).The expression level of chronic hepatitis B patients in each subgroup of serum GP73 in chronic hepatitis B group from high to low is chronic hepatitis B severe chronic hepatitis B>moderate mild chronic hepatitis B>mild hepatitis B,the difference was statistically significant(p<0.01);The expression of serum GP73 in patients with decompensated cirrhosis group was higher than compensated cirrhosis,the difference was statistically significant(p < 0.01).There was a positive correlation between serum GP73 and ALT in chronic hepatitis B group(p<0.01,r=0.580),but there was no correlation between serum GP73 and ALT in patients with chronic severe hepatitis group(r=?0.04,p=0.976);Chronic hepatitis B was negatively correlated with serum levels of GP73 and ALB(r=?0.527,p<0.01),negatively correlated with serum GP73 and ALB of chronic severe hepatitis patients(r= ?0.573,p<0.01);Chronic hepatitis B patients serum GP73 was positively correlated with TBil(r=0.305,p=0.026),serum GP73 in chronic severe hepatitis patients was positively correlated with TBil(r=0.641,p<0.001);The serum GP73 was negatively correlated with PTA in the patients with chronic hepatitis B(r=?0.502,p<0.01).The serum GP73 and PTA were negatively correlated(r=?0.330,p=0.016)in the patients with chronic severe hepatitisThere were different changes in serum GP73,TBil and PT in the patients of the recovery group and the death group during the follow-up period.The expression of GP73 in the death group(308.0±43.88ng/ml)was significantly higher than that in the recovery group(199.35±32.20ng/ml)at the second weeks of follow-up,and the difference was statistically significant(p=0.039).At the second weeks follow-up,the TBil death group(376.88±157.89umol/L)was significantly higher than the recovery group(160.41±94.74umol/L),(p=0.05),but there was no significant difference in the changes of PTA between the two groups at the second weeks follow-up(p=0.524).According to the ROC curve,serum GP73 at the second week of follow-up on the prognosis of patients with chronic severe hepatitis has a certain predictive value(AUC=0.864),when the cut-off value was 259.43ng/ml,prognosis of patients with poor sensitivity and specificity was 97.1%,the specificity was 63.2%(95%CI:75.5%-97.2%).Conclusion: 1.The expression level of GP73 in patients with chronic severe hepatitis caused by HBV infection is significantly higher than that in patients with chronic hepatitis B or cirrhosis.2.High level of serum GP73 level may indicate severe condition and heavy liver injury,and serum GP73 may be a potentialan serological index to assess the degree of liver injury.3.Through the short-term(3 months)follow-up of patients with chronic severe hepatitis showed that serum GP73 may have prognostic value in patiens with chronic severe hepatitis in second weeks,and combined with traditional indicators of liver disease,we can more comprehensively evaluate the severity and severity of liver injury,as well as short-term prognosis of patients. |
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