High-mobility group protein B1: A predictive biomarker for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt
High-mobility group protein B1: A predictive biomarker for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt
复制标题
高迁移率族蛋白 B1：经颈静脉肝内门体分流术后肝性脑病的预测生物标志物
DOI：
10.1002/jhbp.770
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发表时间：
2020-07-13
影响因子：
3
通讯作者：
Liu, Fu-Quan
中科院分区：
文献类型：
--
作者：
Chen, Quan;Zhang, Yu;Liu, Fu-Quan
背景：本研究旨在探讨门静脉高迁移率族蛋白B1(HMGB1)水平与经颈静脉肝内门体分流术(TIPS)后肝性脑病(HE)的关系。方法自2017年12月至2019年5月在我科连续收集门静脉和外周血标本127例。用酶联免疫吸附测定试剂盒检测HMGB1水平。通过竞争风险分析、受试者操作特征(ROC)分析和Kaplan-Meier分析估计HMGB1和其他HE相关参数。结果TIPS后发生HE的患者年龄较大(P=0.019)，门静脉血HMGB1水平高于未发生HE的患者(P=0.038)。单因素竞争风险分析：年龄(自发性高血压1.025，P=0.026)、肝肾综合征(自发性高血压3.149，P=0.010)、终末期肝病(MELD)评分(自发性高血压1.055，P=0.024)、既往高血压(自发性高血压4.029，P=0.0005)、TIPS前门脉高血糖(自发性高血压1.177，P=.001)达到统计学意义。多因素分析：年龄(SHR 1.025，P=.037)、MELD评分(1.062 SHR，P=.011)、既往HE(SHR 2.492，P=.030)和TIPS前门静脉血HMGB1水平(SHR 1.217，P=.0002)有显著差异。ROC分析和Kaplan-Meier曲线显示，门静脉血HMGB1水平在TIPS前后的变化(Delta HMGB1)对0.012 ng/mL的临界值有较好的预测价值(AUC=0.748，P&t；001，敏感性=0.743，特异性=0.655)。结论门静脉HMGB1可能是TIPS术后HE的治疗靶点。
Background The aim of the present study was to investigate whether portal level of high-mobility group protein B1 (HMGB1) is associated with hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS). Methods We enrolled 127 consecutive patients who underwent TIPS and collected portal and peripheral blood samples in our department from December 2017 to May 2019. HMGB1 levels were determined using enzyme-linked immunosorbent assay kits. HMGB1 and other HE related parameters were estimated by competing risk analysis, receiver operating characteristic (ROC) analysis and Kaplan-Meier analysis. Results Patients with HE after TIPS were older (P= .019) and had higher portal HMGB1 level (P= .038) than those without. Univariate competing risk analysis: age (sHR 1.025,P = .026), hepatorenal syndrome (sHR 3.149,P = .010), model for end-of-stage liver disease (MELD) score (sHR 1.055,P = .024), prior HE (sHR 4.029,P = .0005), portal HMGB1 before TIPS (sHR 1.177,P= .001) reached statistical significance. Multivariate analysis: age (sHR 1.025,P = .037), MELD score (sHR 1.062,P = .011), prior HE (sHR 2.492,P = .030) and portal HMGB1 level before TIPS (sHR 1.217,P = .0002) were significantly different. ROC analyses and Kaplan-Meier curve showed portal HMGB1 level changes before and after TIPS (Delta HMGB1) had good predictive value in the cut-off 0.012 ng/mL (AUC = 0.748,P< .001, Sensitivity = 0.743, Specificity = 0.655). Conclusions Portal HMGB1 may be a therapeutic target for post-TIPS HE.