Application Value Of Serum Bile Acid Spectrum In Hepatitis B Cirrhosis

ObjectivesCompare the serum bile acid spectrum of HBV cirrhosis and healthy control population,explore the application value of bile acid spectrum in suggesting liver injury,judge the clinical classification of liver cirrhosis,analyze the short-term survival of patients with hepatitis B cirrhosis,and look for independent risk factors related to prognosis in the bile acid spectrum.MethodsA total of 48 patients diagnosed with HBV cirrhosis in our hospital from April to December 2018 were collected.Complete medical records were collected and followed up for one year on a regular basis.Fifty patients with normal physical examination in our hospital were selected as the healthy control group.Patients were checked for blood routine,biochemical,coagulation and other indicators.Child-Pugh classification was performed in the liver cirrhosis group and recorded;the liver cirrhosis component was divided into the survival group and the death group according to the one-year survival standard;healthy controls and hepatitis B were collected.The venous blood of the liver cirrhosis group was centrifuged and 500ul of serum was collected,and 15 types of bile acids in the serum were detected by LC-MS method.SPSS 22.0 was used to analyze the data,compare the bile acid spectrum of each group,and use the receiver operating characteristic curve to evaluate the ability of various types of bile acids to diagnose liver injury.Establish Kaplan-Meier survival curve and COX proportional hazard model to screen and compare Pedigree-related independent risk factors affecting prognosis.Results1.There was a significant difference in serum bile acid spectrum between the normal control group and the hepatitis B cirrhosis group(P<0.05).The serum unbound bile acid content decreased,and the combined bile acid content increased significantly;2.There was no difference in the detection values of CA,DCA,UDCA,and GLCA in the bile acid spectrum between the normal control group and Child-Pugh at all levels(P>0.05).CDCA,LCA,GCA,GDCA,GCDCA,GUDCA,TCA,The 11 types of bile acids of TLCA,TDCA,TDCCA,and TUDCA were different in the 4 groups(P<0.05).Among them,8 types of bile acids such as GCA,TCA,and GDCA showed an increasing trend with the increase of liver Child-Pugh grade.Statistical significance(P<0.05);3.In the diagnostic evaluation of the receiver's working characteristic curve,the indicators with higher diagnostic ability for liver injury are TCA,TCDCA,GCA,the area of the ROC curve is 0.946,0.923,and 0.901,and the sensitivity is 82.9%,85.3%,and 87.8%,respectively.The specificity is 92.0%,90.0%,94.0%,and the cut-off values of 15 types of bile acids for the diagnosis of liver injury were obtained;4.Comparison of bile acid pedigree in the hepatitis B liver cirrhosis survival group and the death group.The GCA,GDCA,GCDCA,GUDCA,TCA,TLCA,TDCDA,TUDCA detection values in the death group were significantly higher than those in the survival group(P<0.05);5.Introducing 15 kinds of bile acids into the Kaplain-Meier model,suggesting that GCA,GDCA,GCDCA,GUDCA,TCA,TLCA and TUDCA are related to the survival of patients with hepatitis B cirrhosis(P<0.05),and these 7 indicators are introduced into the COX ratio Risk model,suggesting that GDC A,GUDCA,TCA are independent risk factors related to the short-term prognosis of hepatitis B cirrhosis(P<0.05).ConclusionThe change of bile acid lineage in hepatitis B cirrhosis group was significantly higher than that of healthy control group;the test results can indicate early liver injury and can be used as an effective supplement to Child-Pugh classification to improve the accuracy of liver cirrhosis classification;GDC A,GUDCA,TCA and The short-term prognosis of patients with hepatitis B cirrhosis is related.