血清sCD163、MMP-9对食管胃底静脉曲张破裂出血患者预后的预测价值

摘要/Abstract

摘要： 目的分析血清可溶性血红蛋白清道夫受体(sCD163)、基质金属蛋白酶-9(MMP-9)对食管胃底静脉曲张破裂出血患者(EGVB)预后的预测价值。方法选择2018年1月至2023年11月我院收治的178例EGVB患者作为研究对象,并根据住院预后情况分为死亡组(n=11)、存活组(n=167)。检测患者血清sCD163、MMP-9水平,并进行组间比较。采用受试者工作特征(ROC)曲线评估血清sCD163、MMP-9对EGVB患者预后的预测价值,采用多因素logistic回归分析探讨影响EGVB患者预后的相关因素。结果死亡组EGVB患者血清sCD163、MMP-9水平均高于存活组[(98.96±16.69)pg/mL vs.(157.54±18.46)pg/mL,(88.69±15.66)ng/mL vs.(345.43±35.74)ng/mL](P<0.05)。ROC曲线分析显示,血清sCD163、MMP-9预测EGVB患者死亡的曲线下面积为0.854(95%CI:0.804~0.904)、0.867(95%CI:0.817~0.917),血清sCD163联合MMP-9预测EGVB患者死亡的曲线下面积为0.905(95%CI:0.855~0.955)。多因素分析显示,血清sCD163(OR=3.762,95%CI:1.978~7.155)、MMP-9(OR=3.469,95%CI:1.977~6.089)水平及MELD评分(OR=2.423,95%CI:1.628~3.607)、GBS 评分(OR=2.779,95%CI:1.750~4.413)均为EGVB患者预后死亡的危险因素(P<0.05)。结论血清sCD163、MMP-9水平升高与EGVB患者预后密切相关,且对患者预后具有良好的预测价值。

关键词: 食管胃底静脉曲张破裂出血, 可溶性血红蛋白清道夫受体, 基质金属蛋白酶-9, 预后

Abstract: Objective To evaluate the prognostic value of serum soluble hemoglobin scavenger receptor (sCD163) and matrix metalloproteinase-9 (MMP-9) in cases with esophageal and gastric varices bleeding (EGVB). Methods A total of 178 patients with EGVB admitted to our hospital from January 2018 to November 2023 were selected. They were divided into a death group (n=11) and a survival group (n=167) according to their prognosis. Serum levels of sCD163 and MMP-9 were detected in all subjects after admission and compared among all groups. The prognostic value of serum sCD163 and MMP-9 in patients with EGVB were evaluated by receiver operating characteristic curve (ROC) method , and the related factors affecting the prognosis of cases with EGVB were explored by multi-factor logistics regression. Results The serum levels of sCD163 and MMP-9 in patients with EGVB in the death group were higher than those in the survival group [(98.96±16.69) pg/mL vs. (157.54±18.46) pg/mL, (88.69±15.66) ng/mL vs. (345.43±35.74) ng/mL, respectively] (P<0.05). ROC curve analysis showed that the areas under the curve (AUC) of serum sCD163 and MMP-9, and their combination in predicting the death of patients with EGVB were 0.854 (95%CI: 0.804~0.904) and 0.867 (95%CI: 0.817~0.917), and 0.905 (95%CI: 0.855~0.955), respectively. Serum sCD163 (OR=3.762, 95%CI: 1.978~7.155) and MMP-9 (OR=3.469, 95%CI: 1.977~6.089) levels and MELD score (OR=2.423, 95%CI: 1.628~3.607) and GBS score (OR=2.779, 95%CI: 1.750~4.413) were risk factors associated with motality in patients with EGVB (P<0.05). Conclusion The increments of serum sCD163 and MMP-9 levels are closely related to the prognosis of patients with EGVB, and has good prognostic predicting value, which may to be used as biomarkers to evaluate the patients’ prognosis.

Key words: Esophageal and gastric varices rupture hemorrhage, Soluble hemoglobin scavenger receptor, Matrix metalloproteinase-9, Prognosis

常云丽, 叶静, 陈国裕, 冯灵美, 马嵘, 罗昊. 血清sCD163、MMP-9对食管胃底静脉曲张破裂出血患者预后的预测价值[J]. 肝脏, 2026, 31(2): 191-194.

CHANG Yun-li, YE Jing, CHEN Guo-yu, FENG Ling-mei, MA Rong, LUO Hao. The prognostic value of serum sCD163 and MMP-9 in patients with esophageal and gastric variceal bleeding[J]. Chinese Hepatolgy, 2026, 31(2): 191-194.

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