疑难病杂志2017，Vol.16Issue(6)：575-578,583,5.DOI:10.3969/j.issn.1671-6450.2017.06.009
血清纤维化标志物和肝功能指标在慢性乙型肝炎患者肝纤维化诊断中的价值
The applications of serum fibrosis index and liver function in patients with chronic hepatitis B and its diagnostic value in liver fibrosis
摘要
Abstract
Objective To investigate the applications of serum fibrosis index and liver function in patients with chronic hepatitis B (CHB) and its diagnostic value in liver fibrosis.Methods One hundred and twenty cases of CHB patients and 100 cases of healthy subjects were selected from October 2015 to October 2016.The serum fibrosis indexes[hyaluronic acid (HA), laminin (LN), type Ⅲ procollagen peptide (PⅢP) and type Ⅳ collagen (CⅣ)]and serum liver function indexes of [Total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT) and aspartate aminotransferase (AST)]of two groups were determined.The relationship between serum fibrosis index and liver function was analyzed.The application of serum specific fibrosis markers in the diagnosis of hepatic fibrosis in CHB patients was analyzed by ROC curve.Results The Serum fibrosis indexes (HA, LN, PⅢP, CⅣ) and liver function (TBil, DBil, ALT, AST) of CHB group were higher than those in control group (t=5.236,t=6.789,t=7.852,t=9.236,t=10.123,t=11.425,t=6.023,t=5.456,P<0.01).Serum fibrosis indexes (HA, PⅢP, CⅣ) and liver function (TBil, DBil) of S1-S2 group were higher than S3-S4 group (t=6.140,t=6.825,t=7.114,t=8.236,t=9.012,P<0.05).With the increase of fibrosis, serum ALT and AST levels were significantly decreased (t=6.122,t=5.825,P<0.05).There was no statistically significant difference in LN among all grades (P>0.05).There was a negative correlation between HA, PⅢP, CⅣ and ALT and AST (r=0.326,r=0.345,r=0.318,r=0.318,r=0.330,r=0.310,P<0.05), but there was no correlation between ALT,AST and ALT (r=0.116,r=0.123,r=0.102,r=0.112,P>0.05), but HA, PⅢP and CⅣ were positively correlated with TBiL and DBi in Spearman's correlation analysis (r=0.312,r=0.305;r=0.308,r=0.343,P<0.05).The results of ROC analysis showed that the area under the ROC curve (AUC): CⅣ (0.872)> HA (0.710)> PⅢP (0.523)> LN (0.485) was significantly higher than that of single diagnostic value of a high index.Conclusion The serum fibrosis index is closely related to the changes of liver function in patients with CHB.Serum HA and C Ⅳ can be used as predictors of liver fibrosis.关键词
乙型肝炎,慢性/肝纤维化标志物/肝功能/血清Key words
Hepatitis B,chronic/Serum liver fibrosis/Liver function/Value引用本文复制引用
李萍,王丽,胡蓉,毛创杰,陈治利..血清纤维化标志物和肝功能指标在慢性乙型肝炎患者肝纤维化诊断中的价值[J].疑难病杂志,2017,16(6):575-578,583,5.基金项目
国家科技重大专项课题(2012ZX10005004) （2012ZX10005004）
