昆明医科大学学报2025，Vol.46Issue(4)：123-128,6.DOI:10.12259/j.issn.2095-610X.S20250416
基质金属蛋白酶7、谷氨酰转移酶、总胆汁酸联合诊断胆道闭锁的临床价值
Clinical Value of Matrix Metalloproteinase 7,Glutamyl Transferase,and Total Bile Acids in the Joint Diagnosis of Biliary Atresia
摘要
Abstract
Objective To explore the value of serum matrix metalloproteinase 7 combined with glutamyl transferase and total bile acids in the diagnosis of biliary atresia.Methods 112 children hospitalized in Kunming Children's Hospital with the cholestatic jaundice from July 2023 to September 2024 were selected as the research subjects.According to the surgical exploration,intraoperative cholangiography,liver biopsy and follow-up,the children were divided into the biliary atresia group(BA)(n=52)and non-biliary atresia group(Non-BA)(n=60)respecvely.The age,gender,serum matrix metalloproteinase 7(MMP-7),glutamyl transferase(GGT),alanine aminative aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TB),direct bilirubin(DB),total bile acid(TBA)and aspartate aminotransferase/platelet index(APRI)were compared between the two groups.Statistically significant indicators were included in receiver operating characteristic curve(ROC)analysis,and the area under the ROC curve(AUC)and optimal diagnostic margin(Youden index)were calculated.Results There was no significant difference in age,ALT,AST,DB,TB and APRI levels between the two groups of patients(P>0.05);There was a difference in gender composition ratio between the two groups(P=0.006);MMP-7,GGT,TBA levels in the BA group were significantly higher than those in the Non-BA group,and the difference was statistically significant(P<0.05);the AUC of MMP-7,GGT,and TBA in diagnosing BA were 0.946(95%CI 0.897～0.996),0.857(95%CI 0.789～0.926),0.654(95%CI 0.552～0.755)respectively;When the cut-off value of MMP-7 was 22.37 ng/ml,the sensitivity and specificity for diagnosing BA were 0.923 and 0.933 respectively;When the cut-off value of GGT was 151.5 U/L,the sensitivity and specificity of diagnosing BA were 0.885 and 0.733 respectively;When the cut-off value of TBA was 119.5 μmol/L,the sensitivity and specificity of diagnosing BA were 0.788 and 0.500,respectively.The AUC of MMP-7+GGT and MMP-7+TBA combined to diagnose BA were 0.971(95%CI 0.946～0.997)and 0.943(95%CI 0.889～0.996)respectively.Conclusion Serum MMP-7 has the good diagnostic value as a single indicator for diagnosing BA;MMP-7 combined with GGT is better than a single indicator for diagnosing BA;MMP-7 combined with TBA cannot improve the diagnostic efficiency.关键词
胆道闭锁/基质金属蛋白酶-7/谷氨酰转移酶/胆汁酸类/诊断Key words
Biliary atresia/Matrix metalloproteinase-7/Glutamyl transferase/Bile acids/Diagnosis分类
医药卫生引用本文复制引用
纳钊,杨航,陈莉,李传新,肖晗,白强..基质金属蛋白酶7、谷氨酰转移酶、总胆汁酸联合诊断胆道闭锁的临床价值[J].昆明医科大学学报,2025,46(4):123-128,6.基金项目
云南省教育厅科学研究基金(2024J0381) （2024J0381）
昆明市卫健委卫生科研课题(2020-04-01-113) （2020-04-01-113）
