吉林地区不同肝病患者血清铜蓝蛋白水平分析

王莎莎; 华芳; 焦永庚; 秦二云; 智一晓; 庞梦圆; 徐洪芹; 迟秀梅; 牛俊奇; 华瑞

doi:10.3969/j.issn.1001-5256.2020.09.023

吉林地区不同肝病患者血清铜蓝蛋白水平分析

DOI: 10.3969/j.issn.1001-5256.2020.09.023

1. 吉林大学第一医院肝胆胰内科
2. 吉林大学第一医院心血管内科
3. 吉林省一汽总医院麻醉科

基金项目:

吉林省科技发展计划基金(20200201499JC)；

详细信息

中图分类号: R575
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出版历程
- 收稿日期: 2020-05-17
- 出版日期: 2020-09-20

Serum level of ceruloplasmin in patients with different liver diseases in Jilin,China

Department of Hepatology,The First Hospital of Jilin University
Department of Cardiology,The First Hospital of Jilin University
Department of Anesthesiology,The FAW General Hospital of Jilin Province

Research funding:

摘要

摘要: 目的探讨不同病因、不同疾病阶段的肝病患者血清铜蓝蛋白水平。方法选取吉林大学第一医院肝胆胰内科2012年1月-2018年1月住院的共1077例肝病患者,分析不同肝病患者的血清铜蓝蛋白水平。应用Kruskal-Wallis H检验比较不同肝功能状态的病毒相关性肝病患者的铜蓝蛋白水平,应用Spearman相关性分析方法评估铜蓝蛋白与其他指标之间的相关性。结果在肝豆状核变性组,97.6%（41/42）的患者血清铜蓝蛋白水平低于0.2 g/L,其中88.1%（37/42）低于0.10 g/L。不同肝功能状态的病毒相关性肝病患者血清铜蓝蛋白水平差异显著,其中慢性病毒性肝炎、重症病毒性肝炎以及病毒性肝炎肝硬化患者的血清铜蓝蛋白水平均低于急性病毒性肝炎和病毒相关性肝癌患者（P值分别为0.005、<0.001、0.001、0.027、<0.001、0.001）。在非肝豆状核变性肝病组,24.3%（251/1035）的患者铜蓝蛋白低于0.2 g/L,0.2%低于0.1 g/L。非肝豆状核变性肝病患者的血清铜蓝蛋白与白蛋白、前白蛋白呈正相关,与凝血酶原时间呈负相关（r值分别为0.068、0.09...
- 血浆铜蓝蛋白 /
- 肝疾病 /
- 肝豆状核变性
Abstract: Objective To investigate the serum level of ceruloplasmin in patients with different stages and etiologies of liver diseases.Methods A total of 1077 patients with liver diseases who were hospitalized in Department of Hepatology,The First Hospital of Jilin University,from January 2012 to January 2018 were enrolled,and the serum level of ceruloplasmin was analyzed for the patients with different liver diseases. The Kruskal-Wallis H test was used to compare the level of ceruloplasmin between the patients with virus-related liver diseases with different liver functional states,and a Spearman correlation analysis was used to investigate the correlation of ceruloplasmin with other biomarkers. Results In the Wilson's disease group,97. 6%( 41/42) of the patients had a serum ceruloplasmin level of < 0. 2 g/L and88. 1%( 37/42) had a level of < 0. 1 g/L. In the non-Wilson's disease group,24. 3%( 251/1035) of the patients had a ceruloplasmin level of < 0. 2 g/L and 0. 2% had a level of < 0. 1 g/L. There was a significant difference in the serum level of ceruloplasmin between the patients with virus-related liver diseases with different liver functional states,and the patients with chronic viral hepatitis,severe viral hepatitis,and viral hepatitis cirrhosis had a significantly lower level than those with acute viral hepatitis and virus-related liver cancer( P =0. 005,P < 0. 001,P = 0. 001,P = 0. 027,P < 0. 001,and P = 0. 001). In the patients without Wilson's disease,serum ceruloplasmin was positively correlated with albumin and prealbumin( r = 0. 068 and 0. 091,both P < 0. 05) and was negatively correlated with prothrombin time( r =-0. 297,P < 0. 05). Conclusion Ceruloplasmin often decreases significantly in patients with Wilson's disease,with a slight reduction in patients with other types of liver diseases. For these patients,it should be determined whether the reduction in ceruloplasmin is caused by hepatocyte injury or the presence of Wilson's disease.
- ceruloplasmin /
- liver diseases /
- hepatolenticular degeneration

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参考文献(21)

[1] SIOTTO M,PASQUALETTI P,MARANO M,et al. Automation of o-dianisidine assay for ceruloplasmin activity analyses:Usefulness of investigation in Wilson's disease and in hepatic encephalopathy[J]. J Neural Transm(Vienna),2014,121(10):1281-1286.

[2] LINDER MC. Ceruloplasmin and other copper binding components of blood plasma and their functions:An update[J].Metallomics,2016,8(9):887-905.

[3] INOUE K,AKAIKE T,MIYAMOTO Y,et al. Nitrosothiol formation catalyzed by ceruloplasmin:Implication for cytoprotective mechanism in vivo[J]. J Biol Chem,1999,274(38):27069-27075.

[4] SAMYGINA VR,SOKOLOV AV,BOURENKOV G,et al. Ceruloplasmin:Macromolecular assemblies with iron-containing acute phase proteins[J]. PLo S One,2013,8(7):e67145.

[5] WALKER FJ,FAY PJ. Characterization of an interaction between protein C and ceruloplasmin[J]. J Biol Chem,1990,265(4):1834-1836.

[6] NATESHA RK,NATESHA R,VICTORY D,et al. A prognostic role for ceruloplasmin in the diagnosis of indolent and recurrent inflammation[J]. J Natl Med Assoc,1992,84(9):781-784.

[7] CHEN SR,CHONG YT,LI XH. Pathogenic mecha-nism and clinical diagnosis of hereditary abnormal copper metabolism[J]. J Clin Hepatol,2019,35(8):1667-1672.(in Chinese)陈淑如，崇雨田，李新华．遗传性铜代谢异常的致病机制及临床诊断[J]．临床肝胆病杂志，2019,35(8):1667-1672.

[8] European Association for Study of Liver. EASL clinical practice guidelines:Wilson's disease[J]. J Hepatol,2012,56(3):671-685.

[9] Parkinson’s Disease and Movement Disorders Study Group,Neurology Branch of Chinese Medical Association; Inherited Disease Study Group,Neurology Branch of Chinese Medical Association. Guidelines for the diagnosis and treatment of hepatolenticular degeneration[J]. Chin J Neurol,2008,41(8):566-569.(in Chinese)中华医学会神经病学分会帕金森病及运动障碍学组，中华医学会神经病学分会遗传病学组．肝豆状核变性的诊断与治疗指南[J]．中华神经科杂志，2008,41(8):566-569.

[10] Chinese Society of Infectious Diseases and Parasitology,Chinese Society of Hepatology, Chinese Medical Association.Prevention and treatment of viral hepatitis[J]. Chin J Infect Dis,2001,19(1):56-62.(in Chinese)中华医学会传染病与寄生虫病学分会、肝病学分会．病毒性肝炎防治方案[J]．中华传染病杂志，2001,19(1):56-62.

[11] Liver Cancer Professional Committee of Chinese Anti-Cancer Association. Clinical diagnosis and staging criteria of primary liver cancer[J]. Chin J Hepatol,2001,9(6):324-351.(in Chinese)中国抗癌协会肝癌专业委员会．原发性肝癌的临床诊断与分期标准[J]．中华肝脏病杂志，2001,9(6):324-351.

[12] Liver Failure and Artificial Liver Group,Chinese Society of Infectious Diseases,Chinese Medical Association; Severe Liver Diseases and Artificial Liver Group,Chinese Society of Hepatology,Chinese Medical Association. Guidelines for diagnosis and treatment of liver failure[J]. Inter J Epidemiol Infect Dis,2006,33(4):217-221.(in Chinese)中华医学会感染病学分会肝衰竭与人工肝学组，中华医学会肝病学分会重型肝病与人工肝学组．肝衰竭诊疗指南[J]．国际流行病学传染病学杂志，2006,33(4):217-221.

[13] Drug Induced Liver Disease Study Group,Chinese Society of Hepatology,Chinese Medical Association. Guidelines for the management of drug-induced liver injury[J]. J Chin Hepatol,2015,31(11):1752-1769.(in Chinese)中华医学会肝病学分会药物性肝病学组．药物性肝损伤诊治指南[J]．临床肝胆病杂志，2015,31(11):1752-1769.

[14] CZAJA AJ. Diagnosis and management of autoimmune hepatitis[J]. Clin Liver Dis,2015,19(1):57-79.

[15] CHAPMAN R,FEVERY J,KALLOO A,et al. Diagnosis and management of primary sclerosing cholangitis[J]. Hepatology,2010,51(2):660-678.

[16] Rheumatology branch of Chinese Medical Association. Guidelines for the diagnosis and treatment of autoimmune liver disease[J]. Chin J Rheumatol,2011,15(8):556-558.(in Chinese)中华医学会风湿病学分会．自身免疫性肝病诊断和治疗指南[J]．中华风湿病学杂志，2011,15(8):556-558.

[17] Group of Fatty Liver and Alcoholic Liver Diseases,Society of Hepatology,Chinese medical Association. Guidelines for Management of non-alcoholic fatty liver disease[J]. J Clin Hepatol,2010,26(2):120-124.(in Chinese)中华医学会肝脏病学分会脂肪肝和酒精性肝病学组．非酒精性脂肪性肝病诊疗指南[J]．临床肝胆病杂志，2010,26(2):120-124.

[18] Fatty Liver and Alcoholic Liver Disease Study Group of the Chinese Liver Disease Association,Chinese Medical Association.Guidelines for prevention and treatment of alcoholic liver disease(revised version 2010)[J]. J Clin Hepatol,2010,26(3):229-232.(in Chinese)中华医学会肝病学分会脂肪肝和酒精性肝病学组．酒精性肝病诊疗指南(2010年修订版)[J]．临床肝胆病杂志，2010,26(3):229-232.

[19] BREWER GJ. Diagnosis of Wilson's disease:An experience over three decades[J]. Gut,2000,50(1):136.

[20] STEINDL P,FERENCI P,DIENES HP,et al. Wilson’s disease in patients presenting with liver disease:A diagnostic challenge[J]. Gastroenterology,1997,113(1):212-218.

[21] YANG X,TONG DJ,LIANG J,et al. Ceruloplasmin level of patients with liver disease in China[J]. Chin J Intern Med,2005,44(1):13-15.(in Chinese)杨旭，童德军，梁骏等．中国肝病患者血清铜蓝蛋白水平的研究[J]．中华内科杂志，2005,44(1):13-15.

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