乙型肝炎病毒感染肝硬化AST/ALT和LSM值与Child-Pugh分级及临床分期关系

Relationship between AST/ALT,LSM and Child-Pugh grading,clinical staging in hepatitis B virus infection cirrhosis

目的探讨乙型肝炎病毒(HBV)感染肝硬化天门冬氨酸氨基转移酶(AST)/丙氨酸氨基转移酶(ALT)比值(AST/ALT)、肝脏弹性值(LSM)与Child-Pugh分级、临床分期的关系。方法选取2020年3月-2022年5月在贺州市人民医院就诊的86例HBV感染肝硬化患者为肝硬化组,另取同期62例慢性乙型肝炎患者为乙肝组。测量两组患者AST/ALT和LSM值;分析肝硬化患者AST/ALT和LSM值与Child-Pugh分级、临床分期的关系。结果肝硬化组AST/ALT和LSM值高于乙肝组[(2.37±0.35)vs.(0.93±0.18)、(22.14±3.35)kPa vs.(8.30±2.63)kPa],差异均有统计学意义(t=29.671、27.061,P均<0.05);随着Child-Pugh分级升高,AST/ALT和LSM值逐渐升高,差异均有统计学意义(F=115.153、301.638,P均<0.05);随着临床分期升高,AST/ALT和LSM值逐渐升高,差异均有统计学意义(F=133.057、137.808,P均<0.05);AST/ALT与Child-Pugh分级、临床分期均成正相关(r=0.620、0.596,P均<0.05);LSM值与Child-Pugh分级、临床分期均成正相关(r=0.715、0.524,P均<0.05)。结论HBV感染肝硬化AST/ALT和LSM值与Child-Pugh分级、临床分期密切相关,有助于病情的评估。

Objective To explore the relationship between aspartate aminotransferase(AST)/alanine aminotransferase(ALT)ratio(AST/ALT),liver stiffness measurement(LSM)and Child-Pugh grading,clinical staging in hepatitis B virus(HBV)infection cirrhosis.Methods A total of 86 patients with HBV infection cirrhosis treated in Hezhou People's Hospital were enrolled as cirrhosis group between March 2020 and May 2022,while 62 patients with chronic hepatitis B during the same period were enrolled as hepatitis B group.AST/ALT and LSM in both groups were detected for the analysis of the relationship between AST/ALT and LSM,Child-Pugh grading and clinical staging in patients with liver cirrhosis.Results AST/ALT and LSM in cirrhosis group were greater than those in hepatitis B group[(2.37±0.35)vs.(0.93±0.18),(22.14±3.35)kPa vs.(8.30±2.63)kPa],all the differences were statistically significant(t=29.671,27.061;all P<0.05).With the increase of Child-Pugh grading,AST/ALT and LSM were gradually increased(F=115.153,301.638;all P<0.05).With the increase of clinical staging,AST/ALT and LSM were gradually increased(F=133.057,137.808;all P<0.05).AST/ALT was positively correlated with Child-Pugh grading and clinical staging(r=0.620,0.596;all P<0.05),and LSM value was also positively correlated with them(r=0.715,0.524;all P<0.05).Conclusion AST/ALT and LSM were closely related to Child-Pugh grading and clinical staging in HBV infection cirrhosis,which were conducive to the evaluation of conditions.