河北医学2018，Vol.24Issue(1)：6-10,5.DOI:10.3969/j.issn.1006-6233.2018.01.002
血清胆碱酯酶临床评估HBV感染合并肺结核患者抗结核治疗致肝损伤价值
Clinical Value of Serum Cholinesterase in Evaluating Liver Injury Induced by Antituberculosis Therapy in Patients with HBV Infection and Pulmonary Tuberculosis
摘要
Abstract
Objective:To analyze the clinical value of serum cholinesterase ( CHE) in evaluating liver injury induced by antituberculosis therapy in patients with hepatitis B virus ( HBV) infection and pulmonary tuberculosis. Methods:112 cases of patients with HBV infection and pulmonary tuberculosis ( combined group) , 94 cases of patients with simple pulmonary tuberculosis ( simple group ) and 102 healthy subjects ( healthy group) were enrolled in the study. All patients with pulmonary tuberculosis received antituberculosis treatment. Serum CHE levels and liver function indexes were detected, and the correlation between CHE and liver function indexes was analyzed. Results:During the treatment, the normal rate of liver function, the mild injury rate and the severe injury rate in the combined group were 16.07％, 44.64％ and 39.29％, respectively while those in the simple group was 21.28％, 61.70％ and 17.02％, respectively (P<0.05).The serum CHE level ranged from high to low were the combined group, the simple group and the healthy group, and the difference was statistically significant ( P<0.05) , and the more serious liver injury, the lower serum CHE level (P<0.05). After treatment, the levels of HBV-DNA quantification, total bilirubin(TBIL), alanine amin-otransferase ( ALT) and aspartate aminotransferase ( AST) of the combined group were significantly increased (P<0.05), while CHE level was significantly decreased (P<0.05). Serum CHE was negatively correlated with TBIL, ALT and AST ( r=-0.712, 0.723,0687, P<0.05) . The ROC curve results of liver injury induced by anti tuberculosis treatment and analyzed by serum CHE showed that the area under the curve was 0.912 ( P<0.05) and the diagnostic critical value was 4325.54U/L, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of serum CHE diagnosis were 91.49％, 83.33％, 96.63％, 65. 22％ and 90.18％ with high diagnostic efficiency. Conclusion:Serum CHE can well reflect the degree of liver injury and high diagnostic efficiency in patients with HBV infection and pulmonary tuberculosis during antitu-berculosis treatment, which provides references for early antiviral therapy.关键词
胆碱酯酶/HBV感染/肺结核/肝损伤Key words
Cholinesterase/HBV infection/Pulmonary tuberculosis/Liver injury引用本文复制引用
林涛..血清胆碱酯酶临床评估HBV感染合并肺结核患者抗结核治疗致肝损伤价值[J].河北医学,2018,24(1):6-10,5.基金项目
辽宁省科技攻关计划项目,(编号:20142650325) （编号:20142650325）
