| Objective Analyze the pathological changes of liver function and liver tissue in patients with chronic hepatitis B virus infection with normal and mildly elevated alanine aminotransferase(ALT)(≤2ULN,ULN=40U/L),To further study the correlation and prediction value of serum GP73 on liver inflammation grade and fibrosis stage of chronic hepatitis B virus infection with different levels of ALT.Methods(1)From December 2017 to December 2020,320 cases of ALT normal or slightly elevated chronic hepatitis B infection were collected in General Hospital of Ningxia Medical University liver disease clinic and hospital,100 cases ALT mild elevation.220 cases ALT normal,184 cases were aged>30 years old,36 cases were aged ≤30 years old,82 cases had family history and age>30 years old,16 cases were aged ≤30 years old,102 cases had no family history and age>30 years old,and age ≤30 20 cases of age.All patients in the group underwent liver puncture.(2)ELISA double-antibody sandwich method was used to detect serum GP73 level,and analyze the correlation and predictive value of GP73 level with liver tissue pathological grading and staging.(3)Use SPSS 25.0 statistical software to statistically analyze the liver function,serum GP73 level and other indicators of the two groups of patients to observe whether there are differences.explore the relationship between serum GP73 levels,liver inflammation grades,and fibrosis stages.redictive value of ROC analysis of serum GP73 for liver inflammation grading and fibrosis staging in patients with normal and slightly elevated ALT.Results(1)The serum GP73(57.35±21.82)ng/ml of patients with normal ALT group(≤ULN)was significantly lower than that of patients with mildly elevated ALT group(1-2ULN)(69.30±33.3)ng/ml,p<0.05.(2)In groups with different ALT levels,inflammation(≥G2)occurred: 69%(69/100)in the ALT(1-2ULN)group,51.8%(114/220)in the ALT(≤ULN)group,and ALT(1-2ULN)group was significantly higher than that of ALT(≤ULN)group,p<0.05.Fibrosis(≥S2)occurred: the incidence of ALT(1-2ULN)group was 51%(51/100),ALT(≤ULN)The incidence in the group was 43.6%(96/220),and the results of statistical analysis showed that p>0.05.(3)The serum GP73 level of patients in the ALT(1-2ULN)group was positively correlated with the severity of liver inflammation(G1 ～ G4)and fibrosis stage(S1 ～ S4)(r1=0.923,r2=0.734,p<0.05).Serum GP73 levels in patients with liver inflammation and necrosis(≥G2)and fibrosis(≥S2)were significantly higher than those with liver inflammation and necrosis(<G2)and liver fibrosis(<S2),p<0.05.The sensitivity and specificity of serum GP73 were 94.2% and 64.5% in patients with ≥G2 degree of hepatic inflammatory necrosis.and 88% and 86% in patients with obvious degree of liver fibrosis(≥ S2).(4)The serum GP73 level of patients in the ALT group(≤ULN)was positively correlated with liver inflammation grade(G1 ～ G4)and fibrosis stage(S1 ～ S4)severity(r1=0.825,r2=0.731,p<0.05).Serum GP73 levels in patients with liver inflammation and necrosis(≥G2)and fibrosis(≥S2)were significantly higher than those with liver inflammation(<G2)and liver fibrosis(<S2),p<0.05.The sensitivity and specificity of serum GP73 were 93.9% and64.2% in patients with obvious degree of liver inflammation and necrosis(≥ G2),82.5% and79.3% in patients with obvious degree of liver fibrosis(≥ S2).Conclusion Patients with chronic hepatitis B infection with ALT(≤ULN)still have a higher proportion of liver inflammation(≥G2)and fibrosis(≥S2).Close follow-up of the patient’s transaminase status is required,and antiviral therapy should be actively taken if necessary.with liver inflammation The degree of necrosis and fibrosis increases,and the expression level of serum GP73 also increases,which has a good correlation.Serum GP73 can reflect the damage of liver tissue in patients with chronic hepatitis B virus,and is expected to replace liver biopsy to predict ALT(≤2ULN,ULN=40U/L)whether to take antiviral therapy. |
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