血清生化指标对慢性乙型肝炎肝纤维化及炎症程度的诊断价值

Diagnostic Value of Serum Biochemical Markers for Hepatic Fibrosis and Inflam- mation in Patients With Chronic Hepatitis B

目的:研究血清生化指标对慢性乙型肝炎肝纤维化及炎症程度的诊断价值。方法:对75例慢性乙型肝炎患者进行肝功能检测,包括血清白蛋白(A)、球蛋白(G)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TB)、结合胆红素(CB)、谷氨酰转肽酶(GGT)和碱性磷酸酶(ALP)等。所有病例均行肝穿刺活组织检查,并进行肝组织炎症分级(G)及纤维化分期(S)。结果:一些血清学指标与肝组织炎症分级有一定的相关性,以ALT、AST、ALT/AST、A、G、A/G相关性最好,相关系数分别为0.247、0.273、0.424、0.646、0.423、0.579。伴随肝脏炎症及纤维化程度的增加,血清白蛋白水平趋于下降,球蛋白水平增高, 白球比下降;ALT/AST比值亦呈下降趋势。结论:血清生化指标能在一定程度上反映慢性乙型肝炎患者肝纤维化及炎症的程度,但无法划定具体的界值来判断炎症损害程度。

Objective:To study the value of serum biochemical markers in the diagnosis of hepaticr fibrosis and inflammation in patients with chronic hepatitis B. Methods: The level of serum albumin ( A), globulin ( G), ALT, AST, TB, CB, glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) were detected. The pathological degree of hepaticr inflammation and fibrosis was graded by hepaticr biopsy. Results: The level of ALT, AST, ALT/AST, A, G, A/G were correlated with the pathological staging of liver fibrosis and inflammation, the correlation coefficient (r) were 0.247,0.273,0.424,0.646,0.423 and 0. 579 respectively. With the increasing severity of hepatic fibrosis and inflammation,the level of globulin increased and that of albumin,the ratio of A/G and ALT/AST decreased. Conclusion:The serum biochemical markers can at least partly reflect the pathological degree of hepatic inflammation and fibrosis in patients with chronic hepatitis B.