酒精性肝病患者外周血sTim-3、sST2水平与疾病严重程度的相关性

doi:10.11958/20241794

天津医药 ›› 2025, Vol. 53 ›› Issue (4): 383-388.doi: 10.11958/20241794

酒精性肝病患者外周血sTim-3、sST2水平与疾病严重程度的相关性

郑少阳¹(), 智慧², 王曼¹, 武冰¹, 张清格¹, 李冠阳¹

1 邢台市人民医院中西医结合肝病科（邮编054000）
2 河北省民政总医院内科

收稿日期:2024-11-08 修回日期:2025-01-03 出版日期:2025-04-15 发布日期:2025-04-17
作者简介:郑少阳（1988），男，主治医师，主要从事肝病方面研究。E-mail：ganbingkezheng@163.com
基金资助:
邢台市重点研发计划自筹项目(2022ZC136)

Correlation between levels of sTim-3 and sST2 in peripheral blood and disease severity in patients with alcoholic liver disease

ZHENG Shaoyang¹(), ZHI Hui², WANG Man¹, WU Bing¹, ZHANG Qingge¹, LI Guanyang¹

1 Department of Integrated Traditional Chinese and Western Medicine Hepatology, Xingtai People's Hospital, Xingtai 054000, China
2 Department of Internal Medicine, Hebei Provincial Civil Affairs General Hospital

Received:2024-11-08 Revised:2025-01-03 Published:2025-04-15 Online:2025-04-17

郑少阳, 智慧, 王曼, 武冰, 张清格, 李冠阳. 酒精性肝病患者外周血sTim-3、sST2水平与疾病严重程度的相关性[J]. 天津医药, 2025, 53(4): 383-388.

ZHENG Shaoyang, ZHI Hui, WANG Man, WU Bing, ZHANG Qingge, LI Guanyang. Correlation between levels of sTim-3 and sST2 in peripheral blood and disease severity in patients with alcoholic liver disease[J]. Tianjin Medical Journal, 2025, 53(4): 383-388.

摘要/Abstract

摘要：

目的探究酒精性肝病（ALD）患者外周血可溶性T细胞免疫球蛋白黏蛋白分子3（sTim-3）、可溶性生长刺激表达基因2蛋白（sST2）水平与疾病严重程度的相关性。方法纳入ALD患者112例并作为ALD组，其中酒精性脂肪肝（AFL）患者47例（AFL组）、酒精性脂肪性肝炎（ASH）患者37例（ASH组）、酒精性肝硬化（ALC）患者28例（ALC组）。另选取同期112例体检健康者作为对照组。采用酶联免疫吸附试验检测血清sTim-3、sST2水平。受试者工作特征（ROC）曲线分析sTim-3、sST2对ALD不同临床类型的诊断价值。Pearson相关分析血清sTim-3、sST2水平与ALD患者临床指标的相关性。Logistic回归模型分析影响ALD患者疾病严重程度的因素。结果 ALD组血清sTim-3、sST2水平均高于对照组（P<0.05）。AFL组、ASH组、ALC组血清sTim-3、sST2水平依次升高（P<0.05）。sTim-3、sST2联合诊断ALC、ASH的曲线下面积（AUC）大于sTim-3、sST2单独诊断的AUC。AFL组、ASH组、ALC组丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素（TBIL）、碱性磷酸酶（ALP）、谷氨酰转肽酶（GGT）水平依次升高（P<0.05）。血清sTim-3、sST2水平分别与ALT、AST、TBIL、ALP、GGT水平呈正相关（P<0.05）。Logistic回归分析显示，sTim-3、sST2水平较高是ALD患者疾病严重的独立危险因素（P<0.05）。结论 ALD患者血清sTim-3、sST2水平上升，与ALD患者疾病严重程度相关。

关键词: 肝疾病，酒精性, 脂肪肝，酒精性, 肝硬化，酒精性, 甲型肝炎病毒细胞受体2, 可溶性T细胞免疫球蛋白黏蛋白分子3, 生长刺激表达基因2

Abstract:

Objective To investigate levels of soluble T cell immunoglobulin mucin domain 3 (sTim-3) and soluble growth stimulating gene expression protein 2 (sST2) in peripheral blood of patients with alcoholic liver disease (ALD), and their correlation with disease severity. Methods A total of 112 ALD patients in our hospital from June 2021 to June 2023 were selected as the ALD group, including 47 patients with alcoholic fatty liver (AFL group), 37 patients with alcoholic steatohepatitis (ASH group) and 28 patients with alcoholic liver cirrhosis (ALC group). Another 112 healthy subjects were used as the control group. Enzyme linked immunosorbent assay was applied to detect serum levels of sTim-3 and sST2. ROC curve was used to analyze the diagnostic value of sTim-3 and sST2 in different clinical types of ALD. The correlation between serum sTim-3, sST2 levels and clinical indicators in ALD patients was analyzed by Pearson correlation analysis. The factors influencing disease severity in ALD patients was analyzed by Logistic regression model. Results The serum levels of sTim-3 and sST2 were higher in the ALD group than those in the control group (P<0.05). The serum levels of sTim-3 and sST2 were increased successively in the AFL group, the ASH group and the ALC group (P<0.05). The area under the curve (AUC) of the combined diagnosis of ALC and ASH by sTim-3 and sST2 was significantly larger than that of AUC of the single diagnosis of sTim-3 and sST2 (P<0.05). Levels of glutamic-pyruvic transaminase (ALT), glutamic oxalacetic transaminase (AST), total bilirubin (TBIL), alkaline phosphatase (ALP) and glutamyl transpeptidase (GGT) were increased successively in the AFL group, the ASH group and the ALC group (P<0.05). The serum levels of sTim-3 and sST2 were positively correlated with levels of ALT, AST, TBIL, ALP and GGT, respectively (P<0.05). Logistic regression analysis showed that high levels of sTim-3 and sST2 were independent risk factors for severe disease in ALD patients (P<0.05). Conclusion The serum levels of sTim-3 and sST2 increase in ALD patients, which are related to disease severity in ALD patients.

Key words: liver diseases, alcoholic, fatty liver, alcoholic, liver cirrhosis, alcoholic, hepatitis A virus cellular receptor 2, soluble T cell immunoglobulin mucin domain 3, growth stimulating gene expression protein 2

中图分类号:

R575

图/表 10

参考文献 30

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组别	sTim-3/（μg/L）	sST2/（ng/L）
对照组	1.69±0.57	13.06±3.15
ALD组	7.02±0.76	62.58±6.37
t	59.802^＊＊	73.727^＊＊

组别	sTim-3/（μg/L）	sST2/（ng/L）
对照组	1.69±0.57	13.06±3.15
ALD组	7.02±0.76	62.58±6.37
t	59.802^＊＊	73.727^＊＊

组别	n	sTim-3/（μg/L）	sST2/（ng/L）
AFL组	47	6.56±0.76	58.53±5.48
ASH组	37	7.15±0.73^a	63.60±5.89^a
ALC组	28	7.62±0.81^ab	68.02±6.46^ab
F		17.732^＊＊	23.761^＊＊

组别	n	sTim-3/（μg/L）	sST2/（ng/L）
AFL组	47	6.56±0.76	58.53±5.48
ASH组	37	7.15±0.73^a	63.60±5.89^a
ALC组	28	7.62±0.81^ab	68.02±6.46^ab
F		17.732^＊＊	23.761^＊＊

指标	截断值	AUC	95%CI	敏感度	特异度	约登指数
sTim-3	7.37 μg/L	0.738	0.647~0.817	0.714	0.821	0.536
sST2	64.96 ng/L	0.756	0.666~0.833	0.786	0.845	0.631
二者联合		0.870	0.794~0.926	0.893	0.810	0.702

酒精性肝病患者外周血sTim-3、sST2水平与疾病严重程度的相关性

Correlation between levels of sTim-3 and sST2 in peripheral blood and disease severity in patients with alcoholic liver disease

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指标	截断值	AUC	95%CI	敏感度	特异度	约登指数
sTim-3	6.84 μg/L	0.778	0.689~0.851	0.730	0.827	0.556
sST2	62.16 ng/L	0.732	0.640~0.811	0.757	0.840	0.597
二者联合		0.865	0.787~0.922	0.811	0.813	0.624

组别		n		性别（男/女）			年龄/岁			饮酒时间/年
AFL组		47		34/13			50.28±4.22			21.32±1.45
ASH组		37		25/12			50.17±4.30			20.96±1.36
ALC组		28		23/5			49.91±4.54			21.36±1.52
F或χ²				1.758			0.065			0.848
组别			TC/（mmol/L）			ALT/（U/L）		AST/（U/L）
AFL组			4.56±1.06			18.95±5.52		28.24±6.12
ASH组			4.30±0.98			28.59±6.54^a		33.58±6.45^a
ALC组			4.52±1.02			45.34±9.17^ab		41.36±8.47^ab
F			0.723			127.797^＊＊		31.967^＊＊
组别	TBIL/（μmol/L）				ALP/（U/L）				GGT/（U/L）
AFL组	13.06±2.30				110.22±13.74				62.57±6.20
ASH组	16.38±2.46^a				136.72±16.47^a				68.57±8.21^a
ALC组	22.33±2.14^ab				169.84±15.37^ab				89.62±10.52^ab
F	140.556^＊＊				137.888^＊＊				100.573^＊＊

指标	sTim-3	sST2
ALT	0.510^＊＊	0.524^＊＊
AST	0.411^＊＊	0.530^＊＊
TBIL	0.596^＊＊	0.425^＊＊
ALP	0.462^＊＊	0.449^＊＊
GGT	0.417^＊＊	0.506^＊＊

因素	β	SE	Waldχ²	P	OR	95%CI
sTim-3	1.596	0.448	12.687	<0.001	4.932	2.050~11.868
sST2	1.636	0.490	11.154	0.001	5.137	1.966~13.422
常数项	2.384	5.039	0.224	0.636	10.850

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