| Objectives To compare the differences of serum CHI3L1 levels between patients with significant liver fibrosis and those without significant liver fibrosis and healthy people,explore the application value of CHI3L1 in significant liver fibrosis,and compare it with other commonly used indicators to evaluate liver fibrosis,so as to analyze the independent risk factors of significant liver fibrosis in patients with CHB.Methods 81 patients with chronic hepatitis B diagnosed in the Fifth Affiliated Hospital of Zhengzhou University from August 2020 to March 2021 were collected;35 cases normal subjects in the physical examination department of our hospital were selected as the healthy control group.All the participants underwent liver Fibro Scan examination,and improved the four indexes of blood routine,liver function and liver fibrosis.According to whether the LSM value is less than 9.8kpa,CHB patients are divided into no significant liver fibrosis group and significant liver fibrosis group.Collect the venous blood of the participants,collect 500μl serum after centrifugation,and detect the content of serum CHI3L1 by enzyme-linked immunosorbent assay.Spss22 0.The differences of serum CHI3L1 level and various clinical indexes in each group were compared.The diagnostic ability of CHI3L1,GPR,FIB-4 and liver fibrosis for significant liver fibrosis was evaluated by subject working characteristic curve;The indexes with P < 0.05 in univariate analysis were included in the multivariate logistic regression model to screen the independent risk factors of significant liver fibrosis.The correlation between chi3l1 and various clinical indexes was analyzed.Results1.There was no statistical difference in the level of serum CHI3L1 between the healthy control group and the group without significant liver fibrosis(P > 0.05).The level of serum CHI3L1 in the group with significant liver fibrosis was significantly higher than that in the healthy control group and the group without significant liver fibrosis(P < 0.05).2.The levels of serum CHI3L1 in the group with significant liver fibrosis were significantly higher than those in the group without significant liver fibrosis(P <0.001),AST,ALP,GGT,FIB-4,GPR,LN,PIIINP,C-IV,HA and age were also significantly higher than those in the group without significant liver fibrosis(P <0.05),and ALB and PLT were significantly lower than those in the group without significant liver fibrosis(P < 0.05);There was no statistical difference in gender,ALT,IBIL,DBIL,APRI and BMI between the two groups(P > 0.05).3.In the diagnostic evaluation of the working characteristic curve of subjects,the area under the curve of CHI3L1 is 0.895,which is larger than that of GPR,FIB-4,HA,C-IV,LN and PIIINP.The critical values of CHI3L1,GPR and FIB-4 in the diagnosis of significant liver fibrosis are 84.5 ng/m L,0.15 and 1.23 respectively,the sensitivity is 83.3%,70.0% and 76.7%,and the specificity is 80.4%,70.6% and72.5% respectively.4.Logistic regression model analysis showed that CHI3L1 > 84.5 ng/m L,GPR > 0.15 and FIB-4 > 1.23 were independent risk factors for significant liver fibrosis in CHB patients,and the risk of significant liver fibrosis in CHB patients with CHI3L1 > 84.5 ng/m L was 25.612 times higher than that in CHB patients with CHI3L1 ≤ 84.5 ng/m L(OR = 25.612,P = 0.001).5.In CHB patients with serum CHI3L1 > 84.5 ng/m L,AST,DBIL,GGT,GPR,HA,LN,C-IV and PIIINP were higher,while PLT and ALB were lower(P < 0.05).6.Spearman correlation analysis of CHI3L1 and various clinical indexes showed that CHI3L1 was positively correlated with HA,LN,PIIINP,C-IV,LSM and AST,negatively correlated with PLT and ALB,and strongly correlated with HA,LN,C-IV and LSM(P < 0.001).Conclusion CHI3L1 can be used as a good indicator for predicting significant liver fibrosis in CHB patients,and its ability to predict significant liver fibrosis is better than FIB-4,LN,CHB patients with HA,PIIINP,C-IV;CHB patients with CHI3L1 > 84.5ng/m L,GPR > 0.15 and FIB-4 > 1.23 had a significantly increased risk of significant liver fibrosis. |
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