常用肝功能指标诊断病毒性肝炎的多因素分析

Multvariate analysis on the items of liver function test in patients with viral hepatitis

目的探讨肝功能指标间的内在联系,为临床诊断病毒性肝炎提供依据。方法从指标间的数量关系出发,运用多因素统计分析方法,在206例病毒性肝炎患者对10项常用肝功能诊断指标总蛋白(TP)、白蛋白(ALB)、球蛋白(GLB)、白/球(A/G)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、谷草/谷丙比值(AST/ALT)进行聚类分析和类别回归分析。结果10项指标分为5类:胆红素类(TBIL,DBIL,IBIL)、白、球蛋白类(ALB,GLB,A/G)、转氨酶类(ALT,AST)、转氨酶比值类(AST/ALT)、总蛋白(TP)。各类指标预示病情程度的作用大小为:胆红素类>白、球蛋白类>转氨酶类>总蛋白类>转氨酶化值类。在胆红素类中,TBIL的作用最大;在白、球白类中,A/G的作用最大。结论胆红素和白、球蛋白类是判断病情的灵敏指标,其中又以TBIL和A/G比值更为重要。

Objective To study the relationship among the items of liver function test so as to offer some evidence for diagnosing patient condition in clinic. Methods In view of the numerical relationship among the items, ten conventional items of liver function test： TP,ALB,GLB,A/G,TBIL,DBIL, IBIL,AST,ALT,ASY/ALT in 206 patients were studied by multivariate analyses. Results The ten items were divided into 5 clusters; TBIL, DBIL, IBIL; ALB, GLB, A/G; AST, ALT; TP; AST/ALT. The relative importance of the 5 clusters in diagnosing patient condition of liver disease was TBIL,DBIL,IBIL 〉 ALB ,GLB,A/G 〉 AST,ALT 〉 TP 〉 ASY/ALT. TBIL was more important than others in its own cluster and so did A/G. Conclusion TBIL,DBIL,IBIL and ALB ,GLB,A/G are sensitive items in diagnosing patient condition of liver disease and TBIL and A/G are more important.