만성 B형간염 환자에서 간의 염증괴사 활동도 예측을 위한 혈청 마커의 개발

Alternative Title
Hyo-jung Cho
Author(s)
Cho, Hyo Jung
Alternative Author(s)
Hyo-jung Cho
Advisor
정재연
Department
일반대학원 의학과
Publisher
The Graduate School, Ajou University
Publication Year
2013-08
Language
eng
Keyword
apoptosischronic hepatitis Bcytokeratin-18significant inflammation
Abstract
목적: 이 연구의 목적은 만성 B형간염 환자에서 중등도 이상의 염증 괴사 활동도를 예측하는 혈청 마커를 개발하는 것이다. 방법: 간 조직 검사를 시행한 만성 B형 간염 환자 총 384명의 환자가 연구에 포함 되었다. 결과: 혈청 ALT 및 Hyaluronic acid(HA), procollagen III N-terminal peptide(PIIINP)가 Batts-Lugwig inflammatory activity grade 3 이상의 염증 정도를 예측하는 독립 인자였으며, 이 항목들을 이용하여 중등도 이상의 염증괴사 활동도를 예측하기 위한 식을 개발하였다. Significant inflammation (SI) score = 1.773 × ALT score + 1.599 × PIIINP score + 0.677 × HA score  1.962. SI score의 ROC 곡선 아래 역역은 0.831 이었고, 민감도 및 특이도, 양성 예측도, 음성 예측도는 각각 79.5%, 70.8%, 76.8%, 74.3% 였다. 결론: 만성 B형 간염 환자에서 ALT, hyaluronic acid (HA) and procollagen III N-terminal peptide (PIIINP)를 이용하여 비침습적이고 정확한 염증 모델을 개발하였다.
Alternative Abstract
Objectives: The aim of this study was to determine the serum markers that predict significant inflammation in patients with chronic hepatitis B (CHB). Design and Methods: Between October 2005 and June 2009, 384 subjects with CHB were enrolled. Results: Multiple logistic regression analysis identified the ALT, hyaluronic acid (HA) and procollagen III N-terminal peptide (PIIINP) as independent predictors of significant inflammation (grade≥3). We constructed a formula for predicting significant inflammation. A significant inflammation (SI) score = 1.773 × ALT score + 1.599 × PIIINP score + 0.677 × HA score  1.962. The area under receiver operating characteristic curve of the SI score was 0.831. The sensitivity, specificity, positive predictive value and negative predictive value of the SI score were 79.5%, 70.8%, 76.8% and 74.3%, respectively. Conclusions: A simple scoring system including ALT, PIIINP and HA is an accurate non-invasive predictor of significant inflammatory activities in patients with CHB.
URI
https://dspace.ajou.ac.kr/handle/2018.oak/18258
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Graduate School of Ajou University > Department of Medicine > 3. Theses(Master)
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