尿液8-oxo-Gsn和8-oxo-dGsn对HBV感染引起肝损伤程度的价值评估
投稿时间:2017-06-06  修订日期:2017-06-16  点此下载全文
引用本文:徐新民,翁卿华,郭杰,方茜,李祥宇,陈哲,郭健,蔡剑平.尿液8-oxo-Gsn和8-oxo-dGsn对HBV感染引起肝损伤程度的价值评估[J].医学研究杂志,2018,47(2):74-78
DOI: 10.11969/j.issn.1673-548X.2018.02.018
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作者单位E-mail
徐新民 100015 首都医科大学附属北京地坛医院检验科  
翁卿华 100730 北京医院、国家老年医学中心/国家卫生和计划生育委员会老年医学重点实验室  
郭杰 100015 首都医科大学附属北京地坛医院检验科  
方茜 100015 首都医科大学附属北京地坛医院检验科  
李祥宇 100730 北京医院、国家老年医学中心/国家卫生和计划生育委员会老年医学重点实验室  
陈哲 100730 北京医院、国家老年医学中心/国家卫生和计划生育委员会老年医学重点实验室  
郭健 100730 北京医院、国家老年医学中心/国家卫生和计划生育委员会老年医学重点实验室  
蔡剑平 100730 北京医院、国家老年医学中心/国家卫生和计划生育委员会老年医学重点实验室 caijp61@vip.sina.com 
基金项目:北京市优秀人才培养基金资助项目(青年骨干个人项目)(2014000021469G235)
中文摘要:目的 探讨尿液中核酸氧化代谢产物8-oxo-Gsn和8-oxo-dGsn对HBV感染引起肝损伤程度的评估价值。方法 收集笔者医院94例慢性乙型肝炎(以下简称慢乙肝)患者行超声引导下肝穿刺活检前的尿液,95例健康者以及25例乙肝表面携带者的随机尿液,采用同位素稀释高效液相-串联质谱法(ID-LC-MS/MS)分析尿液中DNA氧化标志物8-oxo-dGsn和RNA氧化标志物8-oxo-Gsn,并结合病理结果和生化指标(ALT和AST),分析各指标之间的相关性,通过ROC曲线评估二者对肝损伤程度的预测价值,并分析8-oxo-Gsn和8-oxo-dGsn在不同炎症活动度和不同纤维化程度患者中的水平差异。结果 实验组中,88.5%(46/52)的男性8-oxo-Gsn高于正常对照组,85.7%(36/42)的女性8-oxo-Gsn高于正常对照组;肝脏炎症程度高的患者(G3~G4)尿液中RNA氧化标志物8-oxo-Gsn显著高于炎症程度低的患者(G0~G2)(4.28 vs 3.26,χ2=11.117,P=0.009),纤维化程度高的患者8-oxo-Gsn水平也高于纤维化程度低的患者(3.66 vs 3.29),但未达到显著性水平(χ2=3.626,P=0.323)。尿液中RNA氧化标志物8-oxo-Gsn对肝脏炎症程度有较好的预测价值(敏感度为82.4%,特异性为75%,AUC=0.813),对纤维化程度有较好的预测价值(敏感度为83.3%,特异性为77.1%,AUC=0.824)。结论 尿液中RNA氧化标志物8-oxo-Gsn可能是HBV感染引起的肝损伤严重程度的评估指标。
中文关键词:8-oxo-Gsn  8-oxo-dGsn  HBV感染  肝脏损伤
 
Evaluation of Urinary 8-oxo-Gsn and 8-oxo-dGsn for the Extent of Liver Damage Caused by HBV Infection
Abstract:Objective To explore the evaluation of urine nucleic acid oxidation metabolites 8-oxo-Gsn and 8-oxo-dGsn in severity of liver damage caused by HBV infection.Methods We collected the urine of 94 cases of patients with chronic hepatitis B infection, 95 cases of healthy people and 25 cases of hepatitis B surface antigen carrier in our hospital.Isotope dilution high performance liquid chromatography-tandem mass spectrometry(ID-LC-MS/MS) method was used for analyzing urine DNA oxidation indicator 8-oxo-dGsn and RNA oxidation index 8-oxo-Gsn, and we combined with the results of pathology and biochemical marker (ALT and AST) to analyze the correlation. ROC curve was made to evaluate the predictive value of 8-oxo-Gsn and 8-oxo-dGsn to the extent of liver damge. We also analyzed the difference of 8-oxo-Gsn and 8-oxo-dGsn in different degrees of inflammation and different degrees of fibrosis.Results 88.5% (46/52) of the male 8-oxo-Gsn in experimental group was higher than the control group and 85.7% (36/42) of the female 8-oxo-Gsn in experimental group was higher than the control group.Urine RNA oxidation marker 8-oxo-Gsn was significantly higher in high degree of liver inflammation (G3-G4) than low degree of liver inflammation (G0-G2) (4.98 vs 3.72,χ2=11.117,P=0.009). The level of 8-oxo-Gsn in patients with a high fibrosis degree was also higher than that in patients with low fibrosis degree (3.66 vs 3.29), but not at a significant level(χ2=3.626,P=0.323). RNA oxidation index in urine 8-oxo-Gsn had a good predictive value for liver inflammation (sensitivity 82.4%, specificity 75%, AUC=0.813) and also had a good predictive value for the degree of fibrosis (sensitivity 83.3%, specificity 77.1%, AUC=0.824).Conclusion Urine RNA oxidation marker 8-oxo-Gsn may be a good assessment marker for the degree of liver damage caused by HBV infection.
keywords:8-oxo-Gsn  8-oxo-dGsn  HBV infection  Liver damage
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