Study On The Diagnosis And Severity Of Cirrhosis With The Expression Of STim-3

Objectives:Serum sTim-3 levels were measured in patients with cirrhosis to verify whether there is a difference in serum sTim-3 levels between the patients and the healthy controls.Exploring whether There is diagnostic value or a correlation between sTim-3 and cirrhosis liver function,or there is a difference in sTim-3 between cirrhosis caused by different causes.To find the relationship between sTim-3 and child-pugh grading as well as the related biochemical indicators of cirrhosis.Thus,provide new ideas for early diagnosis of liver cirrhosis and judgment of the degree of disease progression.Methods:109 patients with cirrhosis and 25 healthy controls chosen from the Second Affiliated Hospital of Kunming Medical University from October 1st,2018 to March 1st,2019,2ml of their blood samples were collected,and placed in a drying tube without any additives.After standing at room temperature for 2 h,the centrifuge was centrifuged at 1000 x g for 20 min,and the supernatant was taken,and then labeled and stored at-80? for use.The expression of sTim-3 in serum was detected by ELISA.According to whether the patients were infected with HBV,they were divided into HBV-infected group and non-HBV-infected group;and divided into child A group,child B group and child C group according to the child-pugh classification 1.Analyze the relationship between the expression level of sTim-3 in healthy controls and the cirrhosis;2.Comparison of sTim-3 expression levels between patients with liver cirrhosis caused by various causes such as hepatitis B cirrhosis patients,hepatitis C cirrhosis patients,autoimmune liver disease patients,alcoholic cirrhosis and nonalcoholic fatty cirrhosis;3.comparing the relationship between serum sTim-3 expression levels in child A,child B,child C with HBV infection and non-HBV infection respectively.Results:1 Comparison of sTim-3 levels between patients with cirrhosis and the healthy controls.Compared with healthy people's sTim-3 level,the median level of sTim-3 in patients with cirrhosis was higher than that in the healthy controls,and the difference was statistically significant.2 Analysis of the diagnostic value of sTim-3.The ROC curve of sTim-3 for diagnosing cirrhosis showed that when the serum sTim-3 level was>126.94 pg/ml,there was a higher risk of cirrhosis;And the ROC curve of sTim-3 for diagnosing cirrhosis showed that when the serum sTim-3 level was>225.34 pg/ml,there was a higher risk of hepatitis B cirrhosis.3 Comparison of sTim-3 levels in patients with liver cirrhosis infected by different hepatitis viruses.The level of sTim-3 in HBV-infected patients was significantly higher than that in HCV-infected patients and those not infected with hepatitis virus,and the difference was statistically significant(p<0.001).Further pairwise comparison showed no significant difference in sTim-3 levels between HCV-infected and uninfected hepatitis virus(p>0.05).4 Comparison of sTim-3 levels in patients with cirrhosis of different etiology.The level of sTim-3 in patients with hepatitis B cirrhosis is higher than that in patients with hepatitis C cirrhosis,alcoholic cirrhosis,nonalcoholic cirrhosis,autoimmune cirrhosis and other causes of cirrhosis.The difference is statistically significant.(p<0.001),further pairwise comparison showed that the level of sTim-3 in patients with hepatitis B cirrhosis was higher than that of the other five causes,the difference was statistically significant(p<0.05).Simultaneously,there was no significant difference in sTim-3 levels between other five causes patients(p>0.05).5 Comparison of sTim-3 levels in patients with cirrhosis of different genders.There were no significant differences in sTim-3 levels between the gender,neither the patients with HBV infection,nor uninfected HBV(P>0.05).6 Comparison of sTim-3 levels in patients with cirrhosis of different degrees of ascitesThere were no significant differences in sTim-3 levels between the different degrees of ascites,neither the patients with HBV infection,nor uninfected HBV(P>0.05).7 Comparison of sTim-3 levels in patients with different Child-pugh grades.All patients with cirrhosis were classified according to different Child-pugh criteria.The sTim-3 level of grade A was lowest than others.And the level of sTim-3 of the grade B was lower than that of grade C,but the difference was not statistically significant(P>0.05).All patients with cirrhosis were grouped according to whether they were infected with HBV and then grouped by child-pugh.After comparison,it was found that the difference between groups was also not statistically significant.8 Multiple linear regression analysis of the influencing factors of sTim-3.Hepatitis B virus load,globulin and albumin were independent influencing factors of serum sTim-3 in patients with cirrhosis,and the results were statistically significant(p<0.05).Hepatitis B virus load and globulin were independent factors influencing serum sTim-3 in the HBV-infected group,and the results were statistically significant(p<0.05).In the uninfected HBV group,direct bilirubin was an independent influencing factor for serum sTim-3,and the results were statistically significant(p<0.05).Conclusions:The study found that serum sTim-3 levels in patients with cirrhosis were significantly increased,and were associated with the disease,and have a certain diagnostic value for hepatitis B cirrhosis.When the serum sTim-3 level is>225.34 pg/ml,there is a higher risk of hepatitis B cirrhosis.Serum sTim-3 is associated with hepatitis B virus DNA load,AST,ALP,albumin,globulin and bilirubin.Hepatitis B viral load and globulin levels in HBV-infected patients with cirrhosis were independent influencing factors of sTim-3;direct bilirubin levels in non-HBV-infected patients with cirrhosis were independent influencing factors of sTim-3.Quantitative detection of serum sTim-3 may be a biomarker for disease surveillance and viral replication in HBV-infected patients with cirrhosis.