M-CSF、GGT/Alb与慢性HBV感染肝纤维化程度的相关性

摘要/Abstract

摘要： 目的评估巨噬细胞集落刺激因子(M-CSF)和γ-谷氨酰转肽酶/白蛋白比值(GGT/Alb)在慢性HBV感染者中与肝纤维化进展的关联性。方法纳入2020年3月至2021年4月唐山市人民医院就诊的慢性HBV感染者110例,其中无纤维化(F0期)47例、轻中度纤维化(F1-F3期)34例和重度纤维化(F4期)29例。同期随机选取98名健康体检者作为健康对照组。对比各组间M-CSF、GGT/Alb及肝纤维化血清学标志物[透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PC-Ⅲ)、层粘连蛋白(LN)]的水平差异。应用Pearson相关性分析评估M-CSF、GGT/Alb与肝纤维化程度及各指标间的相关性。结果相较于健康对照组,HBV感染组患者M-CSF、GGT/Alb水平显著升高,为(305.16±45.87)pg/mL比(237.39±33.02)pg/mL,0.53(0.38,0.77)比0.30(0.22,0.61)差异有统计学意义(t=12.096,Z=5.683,均P<0.05)。轻中度及重度纤维化组患者的M-CSF、GGT/Alb及HA、Ⅳ-C、PC-Ⅲ、LN水平均高于无纤维化组(P<0.05);且重度纤维化组高于轻中度纤维化组(P<0.05)。Pearson相关性分析显示,慢性HBV感染者M-CSF、GGT/Alb水平均与HA、Ⅳ-C、PC-Ⅲ、LN呈显著正相关(均P<0.05),且M-CSF与GGT/Alb之间也存在显著正相关性(P<0.05)。结论 M-CSF、GGT/Alb在慢性HBV感染者中升高,与肝纤维化严重程度密切相关,二者水平呈正相关,联合检测可能为评估肝纤维化提供有价值的血清学参考。

关键词: 慢性HBV感染, 肝纤维化, 巨噬细胞集落刺激因子, γ-谷氨酰转肽酶, 白蛋白

Abstract: Objective To evaluate the association between macrophage colony-stimulating factor (M-CSF), the ratio of γ-glutamyl transpeptidase to albumin (GGT/Alb), and the progression of liver fibrosis in patients with chronic HBV infection. Methods A cohort of 110 chronic HBV patients treated between March 2020 and April 2021 constituted the HBV infection group. Based on liver biopsy pathology and the Metavir scoring system, patients were stratified into non-fibrosis (F0, n=47), mild-moderate fibrosis (F1-F3, n=34), and severe fibrosis (F4, n=29) subgroups. Ninety-eight contemporaneous healthy individuals served as the control group. Levels of M-CSF, GGT/Alb, and established liver fibrosis markers [hyaluronic acid (HA), type Ⅳ collagen (Ⅳ-C), type III procollagen (PC-Ⅲ), laminin (LN)] were measured and compared amomg groups. Pearson correlation analysis was employed to examine the relationships between M-CSF, GGT/Alb, fibrosis severity, and other markers. Results M-CSF and GGT/Alb levels were significantly elevated in the HBV group compared to controls [(305.16±45.87) pg/mL vs (237.39±33.02) pg/mL,0.53 (0.38,0.77) vs 0.30 (0.22,0.61)] (P<0.05). Within the HBV group, levels of M-CSF, GGT/Alb, HA, Ⅳ-C, PC-Ⅲ, and LN were significantly higher in both mild-moderate and severe fibrosis subgroups than those in the non-fibrosis subgroup (P<0.05), and further elevated in the severe versus mild-moderate subgroup (P<0.05). Pearson analysis revealed significant positive correlations between both M-CSF and GGT/Alb and the levels of HA, Ⅳ-C, PC-Ⅲ, and LN (all P<0.05) among chronic HBV patients. A significant positive correlation was also found between M-CSF and GGT/Alb (P<0.05). Conclusion Elevated levels of M-CSF and GGT/Alb are closely associated with the severity of liver fibrosis in chronic HBV infection, and there is a positive correlation between the two markers. Their combined assessment may offer valuable serological insights for evaluating liver fibrosis.

Key words: Chronic HBV infection, Liver fibrosis, Macrophage colony-stimulating factor, γ-glutamyl transpeptidase, albumin

崔丽伟, 杜艳明, 马丽丽. M-CSF、GGT/Alb与慢性HBV感染肝纤维化程度的相关性[J]. 肝脏, 2026, 31(3): 361-364.

CUI Li-wei, DU Yan-ming, MA Li-li. Association between M-CSF, GGT/Alb and the degree of liver fibrosis in patients with chronic HBV infection[J]. Chinese Hepatolgy, 2026, 31(3): 361-364.

/ 推荐

参考文献

[1] 陈芳, 喻雪琴, 戢敏, 等.循环血TLR-4、TGF-β1表达水平与HBV相关性肝硬化患者病情程度的相关性分析[J].中国现代医学杂志, 2019, 29(21):71-75.
[2] 吴张君, 潘莹, 乐圆.血清AST、ALP、CHE、PT与乙型病毒性肝炎合并肺结核患者肝纤维化程度的相关性[J].中西医结合肝病杂志, 2020, 30(6):509-511.
[3] 黄圣楷, 符微, 孙龙.慢性HBV感染肝纤维化风险预测列线图模型的建立与验证[J]. 海南医学院学报, 2022, 28(18):1382-1386,1392.
[4] 王殷秋, 曹雯君, 郜玉峰, 等. M-CSF血清水平与慢性HBV感染患者肝脏纤维化程度的相关性研究[J].安徽医科大学学报, 2018, 53(4):614-618.
[5] 何峰, 郜玉峰, 王翔, 等.GGT/Alb比值对慢性HBV感染者肝纤维化的无创诊断价值[J]. 临床肝胆病杂志, 2021, 37(6):1309-1313.
[6] 中华医学会感染病学分会, 中华医学会肝病学分会.慢性乙型肝炎防治指南(2019年版)[J].中国病毒病杂志, 2020, 10(1):1-25.
[7] Li T Y, Yang Y, Zhou G, et al. Immune suppression in chronic hepatitis B infection associated liver disease: a review[J]. World J Gastroenterol, 2019, 25(27):3527-3537.
[8] Öznur M, Topçu B, Çelikkol A. Predictive value of noninvasive indices in chronic hepatitis B virus-related fibrosis[J]. Eur J Gastroenterol Hepatol, 2021, 33(4):577-582.
[9] 徐杰, 钟明利, 王跃峰, 等.狗肝菜多糖干预MAPK信号通路抑制炎症反应缓解大鼠肝纤维化进程[J].中国药理学通报, 2022, 38(4):531-537.
[10] Preisser L, Miot C, Le Guillou-Guillemette H, et a1.IL-34 and macrophage colony—stimulating factor are overexpmssed in hepatitis C virus fibrosis and induce profibmtic maerophages that promote collagen synthesis by hepatic stellate cells[J].Hepatology, 2014, 60(6):1879-1890.
[11] 王殷秋, 曹雯君.IL-34、M-CSF与肝纤维化、肝癌的相关性研究进展[J]. 安徽医科大学学报, 2018, 53(3):487-490.
[12] Ao J Y, Zhu X D, Chai Z T, et al. Colony-stimulating factor 1 receptor blockade inhibits tumor growth by altering the polarization of tumor-associated macrophages in hepatocellular carcinoma[J]. Mol Cancer Ther, 2017, 16(8):1544-1554.
[13] Cho Y, Joshi R, Lowe P, et al. Granulocyte colony-stimulating factor attenuates liver damage by M2 macrophage polarization and hepatocyte proliferation in alcoholic hepatitis in mice[J]. Hepatol Commun, 2022,6(9):2322-2339.
[14] 李睿, 陈传国, 朱茂治.慢性阻塞性肺疾病急性加重患者血清GGT水平与炎症因子及肺功能的关系[J].中国医药导报, 2020, 17(27):175-178,182.
[15] Huang C F, Jang T Y, Jun D W, et al. On-treatment gamma-glutamyl transferase predicts the development of hepatocellular carcinoma in chronic hepatitis B patients[J]. Liver Int, 2022, 42(1):59-68.
[16] 孙立娜, 王云飞, 颜利求, 等. Logistic回归模型拟合临床因素、营养状况、炎症指标对维持性血液透析患者并发肺部感染的预测价值[J].解放军医药杂志, 2022(4):50-54.
[17] 曹志娟, 江东, 邓静, 等.肝硬化患者的免疫功能障碍和白蛋白相关免疫、肝纤维化进展的相关性研究[J]. 现代生物医学进展, 2022, 22(9):1734-1738.
[18] 刘旭东,赵壮志,吕萍,等.FibroTouch诊断慢性乙型肝炎肝纤维化的影响因素及临床价值[J]. 中西医结合肝病杂志, 2020, 30(3):261-264.
[19] Yang J G, He X F, Huang B, et al. Rule of changes in serum GGT levels and GGT/ALT and AST/ALT ratios in primary hepatic carcinoma patients with different AFP levels[J]. Cancer Biomark, 2018, 21(4): 743-746.
[20] 凌淳, 李媛媛.40岁以上HBeAg阴性慢性乙肝患者血清HBV DNA水平与肝纤维化的关系探讨[J].贵州医药, 2022, 46(1): 27-28.