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目的对539例肝病患者的肝纤维化相关指标进行聚类分析,探讨与疾病诊断和预测的相关性。方法选取2015年2月-9月在本院门诊和住院的肝病患者539例,免疫荧光法检测透明质酸(hyaluronic acid,HA)、层粘连蛋白(laminin,LN)、Ⅳ型胶原(Ⅳ)、Ⅲ前胶原(Ⅲ)等肝纤维化指标。结果系统聚类法分为3类:A类(HA~(high)/LN~(high)/GGT~(high))、B类(ALT~(high)/AST~(high)/HA~(medium))、C类(HA~(low)/LN~(low)/Ⅲ/~(medium-low)/Ⅳ~(medium-low))。A类中肝硬化晚期(57.1%)和肝癌患者(34.9%)比例均高于其他分类,差异有统计学意义(χ~2值分别为213.57、148.30,P<0.01);B类中急性肝损伤比例(53.4%)均高于其他分类,差异有统计学意义(χ~2=238.60,P<0.01);C类中肝硬化早期(33.2%)、病毒性肝炎(47.2%)、脂肪肝(28.8%)比例均高于其他分类,差异有统计学意义(χ~2值分别为40.71、34.28、29.71,P<0.01)。结论对肝病患者肝纤维化相关指标进行聚类分析有助于针对性预测。
Objective To investigate the correlation between liver fibrosis related indicators of 539 cases of liver disease and the diagnosis and prediction of the disease. Methods 539 cases of liver disease in outpatient department and inpatient hospital from February to September in 2015 were selected. The expression of hyaluronic acid (HA), laminin (LN), type Ⅳ collagen (Ⅳ) , Ⅲ procollagen (Ⅲ) indicators of liver fibrosis. Results The results of cluster analysis were divided into three categories: A group (HA high / LN high / GGT high), B high ALT high / HA high Medium), Class C (HA low / LN low / medium / low / medium low). The proportion of type A patients with advanced cirrhosis (57.1%) and patients with hepatocellular carcinoma (34.9%) was higher than other groups (χ ~ 2 = 213.57,148.30, P <0.01) (53.4%) were higher than those of the other groups (χ ~ 2 = 238.60, P <0.01). In the early stage of C cirrhosis, the incidence of liver cirrhosis was 33.2%, viral hepatitis was 47.2% (28.8%) were higher than other categories, the difference was statistically significant (χ ~ 2 values were 40.71,34.28,29.71, P <0.01). Conclusion Clustering analysis of liver fibrosis related indicators in liver disease is helpful for the targeted prediction.