血清免疫抑酸性蛋白对亚急性重型肝炎的诊断意义

Diagnostic significance of serum immunosuppressive acidic protein level for subacute severe hepatitis

目的 探讨血清免疫抑酸性蛋白 (IAP)对亚急性重型肝炎的诊断价值。方法 收集亚急性重型肝炎 (5 6例 )和急性肝炎 (95例 )患者血清 ,用单向免疫扩散法检测IAP水平。亚急性重型肝炎与急性肝炎血清IAP水平间比较采用t检验 ,血清IAP对亚急性重型肝炎与急性肝炎的鉴别价值分析采用ROC曲线法。结果 亚急性重型肝炎患者血清IAP水平为 (2 2 2 .14± 15 7.47) μg/ml ,急性肝炎患者为 (3 43 .60± 15 8.2 1) μg/ml ,两者间差异有显著性 (t =1.976,P =0 .0 0 0 )。两组血清IAP水平的ROC曲线下面积为 0 .741,显著大于标准参考线下面积 (P =0 .0 0 0 )。以血清IAP≥2 2 5 μg/ml诊断急性肝炎而排除亚急性重型肝炎的灵敏度、特异度和准确度分别为0 .789、0 .679和 0 .748,阳性和阴性预测值分别为 0 .80 6和 0 .65 5 ,阳性和阴性似然比分别为 2 .45 8和 0 .3 11。结论 血清IAP对亚急性重型肝炎有一定的诊断价值。

Objective To study the diagnostic value of serum immunosuppressive acidic protein (IAP) for subacute severe hepatitis.Methods Serum samples collected from 56 patients with subacute severe hepatitis and 95 patients with acute hepatitis were tested for IAP with one way immunodiffusion assay. ROC curve was used for analyzing the value of serum IAP levels in discriminating subacute severe hepatitis from acute hepatitis.Results Serum IAP levels in subacute severe hepatitis and acute hepatitis were(222.14±157.47)μg/ml and (343.60±158.21)μg/ml respectively, there was a significant difference in serum IAP levels between subacute severe hepatitis and acute hepatitis ( t=1.976,P =0.000). The area under the ROC curve of serum IAP levels for discriminating subacute severe hepatitis from acute hepatitis was 0.741, which was significantly larger than the area under the standard reference line( P =0.000). Taking serum IAP≥225μg/ml as cut off for diagnosing acute hepatitis and excluding subacute severe hepatitis, the sensitivity, specificity and accuracy were 0.789 , 0.679 and 0.748, respectively. The positive and negative predictive value were 0.806 and 0.655, respectively. The positive and negative likelihood ratio were 2.458 and 0.311, respectively.Conclusions Serum IAP determination is of some value in discriminating subacute severe hepatitis from acute hepatitis.