[1]孙广明,夏宇飞,黄龙昌,等.血清铁蛋白可识别肠衰竭相关性肝病[J].肠外与肠内营养杂志,2024,(03):147-153.[doi:DOI : 10.16151/j.1007-810x.2024.03.004]
　SUN Guang-ming,XIA Yu-fei,HUANG Long-chang,et al.Diagnostic value of serum ferritin in intestinal failure-associated liverdisease[J].PARENTERAL & ENTERAL NUTRITION,2024,(03):147-153.[doi:DOI : 10.16151/j.1007-810x.2024.03.004]
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血清铁蛋白可识别肠衰竭相关性肝病()
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2024年03期
页码:
147-153
栏目:
论著
出版日期:
2024-06-10

文章信息/Info

Title:
Diagnostic value of serum ferritin in intestinal failure-associated liverdisease
作者:
孙广明1; 夏宇飞2; 黄龙昌1; 古丽苏杜姆·麦提阿卜拉1; 章 黎1; 高学金1; 王新颖1
1.南京大学医学院附属金陵医院/东部战区总医院 普通外科，江苏南京 210002；2.东南大学医学院，江苏南京 210009
Author(s):
SUN Guang-ming1;  XIA Yu-fei2;  HUANG Long-chang1;  Maitiabula Gulisudumu1;  ZHANG Li1; GAO Xue-jin1;  WANG Xin-ying1
1. Department of General Surgery, Nanjing Jinling Hospital, Affiliated Hospital of Medical School,Nanjing University, Nanjing 210002, Jiangsu, China；2. School of Medicine, Southeast University,Nanjing 210009, Jiangsu, China
关键词:
血清铁蛋白 ; 肠外营养 ; 肠衰竭 ; 肝纤维化
Keywords:
Serum ferritin;  Parenteral nutrition;  Intestinal failure;  Liver fibrosis
分类号:
R656
DOI:
DOI : 10.16151/j.1007-810x.2024.03.004
文献标志码:
A
摘要:
目的：探讨血清铁蛋白在肠衰竭相关性肝病中的诊断价值。 方法：回顾性分析 2019年1月至2022年 12月在南京大学附属金陵医院普通外科收治的成人短肠综合征病人的临床资料，通过线性回归确定血清铁蛋白和肝脏酶谱的相关性，通过多因素Logistic 回归分析筛选肝损伤的潜在危险因素，并建立肝纤维化预测模型。同时计算曲线下面积以评估模型的准确性。 结果：共纳入106例短肠综合征病人，其中血清铁蛋白（SF）升高的有 55例（51.9%）。线性回归分析显示血清铁蛋白和ALT（r = 0.427，P < 0.001）、ALP（r = 0.365，P < 0.001）以及γ-GT（r =0.423，P < 0.001）呈正相关，单因素 Logistic 回归分析显示血清铁蛋白水平越高，差异越明显[SF >ULN（血清铁蛋白正常值上限）, P = 0.033; SF > 1.5 × ULN, P = 0.018; SF > 2.5 × ULN, P = 0.006]。多因素Logistic 回归分析显示：PN依赖（OR = 3.366，P = 0.017）、血清铁蛋白> 2.5 ULN（OR = 3.292，P = 0.014）是肠衰竭相关性肝病—肝纤维化的独立危险因素，受试者工作曲线（ROC）显示曲线下面积为74.8%，95%CI:0.652 ~ 0.844。 结论：血清铁蛋白可作为一个可靠的临床生物标志物，帮助识别肠衰竭相关性肝病。
Abstract:
Objective: To investigate the diagnostic value of serum ferritin in intestinal failure -associated liverdisease. Methods: Clinical data of adult patients with short bowel syndrome admitted to the Department of GeneralSurgery of Jinling Hospital affiliated to Nanjing University from January 2019 to December 2022 were retrospectivelyanalyzed to determine the correlation between serum ferritin and liver enzyme profiles by linear regression, to screen thepotential risk factors of liver injury by multifactorial Logistic regression analysis, and to establish a prediction model forliver fibrosis. The area under the curve was also calculated to assess the accuracy of the model. Results: A total of 106patients with short bowel syndrome were included, of whom 55 (51.9%) had elevated serum ferritin (SF). Linearregression analysis showed a positive correlation between serum ferritin and ALT (r = 0.427, P < 0.001), ALP (r = 0.365,P < 0.001), and γ-GT (r = 0.423, P < 0.001), and one-way Logistic regression analysis showed that the higher the level ofserum ferritin, the more pronounced the difference was (SF > ULN) The one-way logistic regression analysis showedthat the higher the serum ferritin level, the more significant the difference was [SF >ULN (upper limit of normal value ofserum ferritin), P = 0.033; SF >1.5×ULN, P = 0.018; SF > 2.5×ULN, P = 0.006]. Multifactorial logistic regressionanalysis showed that PN dependence (OR = 3.366, P = 0.017) and serum ferritin >2.5 ULN (OR = 3.292, P = 0.014)were independent risk factors for intestinal failure-associated liver disease-liver fibrosis, and the receiver operating curve(ROC) of the subjects showed area under the curve of 74.8%, 95% CI: 0.652 ~ 0.844. Conclusion: Serum ferritin canbe used as a reliable clinical biomarker to help identify intestinal failure-associated liver disease.

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备注/Memo

备注/Memo:
基金项目 ：国家自然科学基金面上项目（81770531；82370900）作者简介 ：孙广明，住院医师，医学博士研究生，从事肠外营养相关性肝病的临床与基础研究。E-mail：18865382023@163.com通讯作者 ：王新颖，E-mail：wangxinying@nju.edu.cn
更新日期/Last Update: 1900-01-01