丙型肝炎患者血清miR-155、miR-205-5p水平变化及诊断价值

doi:10.11958/20231954

摘要/Abstract

摘要：

目的探讨丙型肝炎患者血清miR-155和miR-205-5p表达水平的变化及临床意义。方法收集丙型肝炎患者141例，根据基因分型将其分为丙型肝炎病毒（HCV）-1b组（92例）和非HCV-1b组（49例），另取同期于本院进行体检的健康志愿者141例为对照组。比较3组一般资料、生化指标及血清miR-155、miR-205-5p水平；根据肝炎活动度分级，将丙型肝炎患者分为G0、G1、G2、G3、G4级，比较5组血清miR-155、miR-205-5p水平；受试者工作特征（ROC）曲线分析血清miR-155、miR-205-5p诊断丙型肝炎患者肝炎活动度为G1—G4级的临床价值。结果 HCV-1b组和非HCV-1b组丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素（TBIL）水平均高于对照组，血清白蛋白（ALB）水平低于对照组（P<0.05）；对照组、非HCV-1b组和HCV-1b组血清miR-155水平依次升高，血清miR-205-5p水平依次降低（P<0.05）；随着肝炎活动度分级的增加，血清miR-155水平依次升高，miR-205-5p水平依次下降（P<0.05）；miR-155、miR-205-5p以及两者联合诊断丙型肝炎患者肝炎活动度为G1—G4级的ROC曲线下面积（AUC）分别为0.855、0.793和0.913，联合优于二者各自单独诊断（P<0.05）。结论丙型肝炎患者血清miR-155水平上升，miR-205-5p水平下降，两者联合对肝炎活动度为G1—G4级的诊断具有较高效能。

关键词: 肝炎病毒属, 微RNAs, 丙型肝炎病毒, 微小RNA-155, 微小RNA-205-5p, HCV-1b基因型, 肝炎活动度

Abstract:

Objective To investigate changes and clinical significance of serum microRNA-155 (miR-155) and microRNA-205-5p (miR-205-5p) levels in patients with hepatitis C virus (HCV) infection. Methods A total of 141 patients with HCV infection were collected and divided into the HCV-1b group (92 cases) and the non HCV-1b group (49 cases) according to their genotype, and another 141 healthy volunteers who underwent physical examinations in our hospital during the same period were collected as the control group. The general information, biochemical indicators and serum levels of miR-155 and miR-205-5p were compared between the three groups. According to the grading of hepatitis activity, HCV infected patients were classified into the G0, G1, G2, G3 and G4 groups, and serum levels of miR-155 and miR-205-5p were compared between the five groups. Receiver operating characteristics (ROC) curve was used to analyze clinical values of serum miR-155 and miR-205-5p in diagnosing hepatitis activity of G1-G4 in patients with HCV infection. Results The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) were obviously higher in the HCV-1b group and the non HCV-1b group than those in the control group, while the level of ALB was obviously lower than that in the control group (P<0.05). The serum level of miR-155 was increased in turn in the control group, the non-HCV-1b group and the HCV-1b group, and the serum level of miR-205-5p was decreased in turn (P<0.05). The serum level of miR-155 increased in turn with the increased grading of hepatitis activity, while the serum miR-205-5p level decreased in turn (P<0.05). The area under curve (AUC) values of serum miR-155, miR-205-5p and their combination in diagnosing hepatitis activity of G1-G4 in HCV infected patients were 0.855, 0.793 and 0.913, respectively, and the combination of the two is superior to each individual diagnosis (P<0.05). Conclusion The serum miR-155 level increases and miR-205-5p level decreases in HCV infected patients. The combination of the two has high efficacy in diagnosing hepatitis activity of G1-G4 in HCV infected patients.

Key words: hepacivirus, microRNAs, hepatitis C virus, miR-155, miR-205-5p, HCV-1b genotype, hepatitis activity

中图分类号:

R373.21，R512.63

图/表 5

参考文献 21

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组别	n		男性	年龄/岁		BMI/（kg/m²）		LDL-C/（mmol/L）		HDL-C/（mmol/L）		WBC/（×10⁹/L）		RBC/（×10¹²/L）
对照组	141		76（53.9）	46.34±8.64		23.29±2.26		2.35±0.36		1.24±0.32		6.24±1.49		5.43±1.23
非HCV-1b组	49		28（59.2）	47.57±8.92		23.70±2.31		2.41±0.43		1.26±0.34		6.12±1.46		5.21±1.16
HCV-1b组	92		53（57.6）	46.86±8.37		23.41±2.15		2.37±0.52		1.23±0.31		6.51±1.53		5.64±1.35
χ²或F			0.362	0.389		0.614		0.357		0.140		1.367		1.946
组别		ALT/（U/L）			AST/（U/L）		LDH/（U/L）		ALB/（g/L）		TBIL/（μmol/L）		GLU/（mmol/L）
对照组		27.26±6.91			22.44±5.62		184.61±31.33		45.12±11.33		6.26±1.52		5.46±1.03
非HCV-1b组		48.22±10.35^a			35.26±11.37^a		186.42±30.76		38.32±9.25^a		10.16±3.58^a		5.14±1.01
HCV-1b组		50.17±12.51^a			37.35±11.62^a		190.37±34.21		41.21±10.36^a		10.32±3.64^a		5.22±1.06
F		187.127^＊＊			87.195^＊＊		0.895		8.628^＊＊		73.596^＊＊		2.448

组别	n		男性	年龄/岁		BMI/（kg/m²）		LDL-C/（mmol/L）		HDL-C/（mmol/L）		WBC/（×10⁹/L）		RBC/（×10¹²/L）
对照组	141		76（53.9）	46.34±8.64		23.29±2.26		2.35±0.36		1.24±0.32		6.24±1.49		5.43±1.23
非HCV-1b组	49		28（59.2）	47.57±8.92		23.70±2.31		2.41±0.43		1.26±0.34		6.12±1.46		5.21±1.16
HCV-1b组	92		53（57.6）	46.86±8.37		23.41±2.15		2.37±0.52		1.23±0.31		6.51±1.53		5.64±1.35
χ²或F			0.362	0.389		0.614		0.357		0.140		1.367		1.946
组别		ALT/（U/L）			AST/（U/L）		LDH/（U/L）		ALB/（g/L）		TBIL/（μmol/L）		GLU/（mmol/L）
对照组		27.26±6.91			22.44±5.62		184.61±31.33		45.12±11.33		6.26±1.52		5.46±1.03
非HCV-1b组		48.22±10.35^a			35.26±11.37^a		186.42±30.76		38.32±9.25^a		10.16±3.58^a		5.14±1.01
HCV-1b组		50.17±12.51^a			37.35±11.62^a		190.37±34.21		41.21±10.36^a		10.32±3.64^a		5.22±1.06
F		187.127^＊＊			87.195^＊＊		0.895		8.628^＊＊		73.596^＊＊		2.448

组别	n	miR-155	miR-205-5p
对照组	141	1.01±0.19	1.02±0.21
非HCV-1b组	49	2.04±0.54^a	0.66±0.14^a
HCV-1b组	92	2.82±0.77^ab	0.51±0.13^ab
F		356.215^＊＊	249.885^＊＊

组别	n	miR-155	miR-205-5p
对照组	141	1.01±0.19	1.02±0.21
非HCV-1b组	49	2.04±0.54^a	0.66±0.14^a
HCV-1b组	92	2.82±0.77^ab	0.51±0.13^ab
F		356.215^＊＊	249.885^＊＊

肝炎活动度分级	n	miR-155	miR-205-5p
G0级	23	1.87±0.27	0.78±0.15
G1级	33	2.34±0.31^a	0.67±0.13^a
G2级	38	2.56±0.32^ab	0.55±0.11^ab
G3级	27	2.86±0.35^abc	0.43±0.11^abc
G4级	20	3.22±0.37^abcd	0.32±0.09^abcd
F		56.450^＊＊	54.424^＊＊