血清亮氨酸氨基肽酶和腺苷脱氨酶检测在HBV感染性肝病中的临床价值

Clinical significance of leucyl aminopeptidase and adenosine deaminase in liver diseases related to Hepatitis B virus

目的:探讨血清亮氨酸氨基肽酶(LAP)和腺苷脱氨酶(ADA)检测在乙型肝炎病毒(HBV)感染性肝病中的临床应用价值。方法:将HBV感染患者按病情分组,检测所有患者血清LAP、ADA、其它常规肝功能项目及肝纤维化指标,对其中133例患者行肝组织活检,并以正常人为对照组;分析各组血清LAP和ADA的差异及各指标间的相关性。结果:LAP和ADA血清水平的总体差别均有统计学意义(F=24.40、34.94,P均<0.01)。血清LAP以原发性肝癌组(HCC)升高最为显著,诊断HCC时的ROC曲线下面积为0.712。血清ADA水平随肝炎程度加深而升高,以肝硬化组升高最为显著,且与透明质酸和纤维化程度的相关系数大于0.5。结论:血清LAP和ADA检测对各类HBV感染性肝病的诊断及病情估计均有一定价值。特别是血清LAP可作为HCC鉴别诊断的一项初步指标,而血清ADA有助于肝纤维化的诊断。

Objective：To discuss the application value of detecting serum leucyl aminopeptidase（LAP） and adenosine deaminase（ADA） in liver diseases related to Hepatitis B virus.Methods： The patients infected with HBV were divided into different groups according to clinical types.The serum LAP,ADA,other routine liver function markers and serum hepatic fibrosis indices were measured in all patients and with the healthy people as control group,133 patients were made Liver biopsy.Then the serum difference of LAP and ADA in all groups and the relationship between different markers was analyzed.Results： The serum difference of LAP and ADA in all groups have statistical significance（F=24.40,34.94,P〈0.01）.The serum level of LAP in patients with hepatic carcinoma（HCC）was highest in all groups and the area of ROC for HCC was 0.712.The serum level of ADA in patients with liver cirrhosis was highest in all groups,which increased with the hepatic inflammation increasing,and the correlation coefficient with hyaluronic acid and the stage of hepatic fibrosis was above 0.5.Conclusion： The detection of serum LAP and ADA is meaningful for the diagnosis and evaluation of liver diseases related to Hepatitis B virus.Especially serum LAP can be used for the differential diagnosis of HCC and serum ADA is helpful for the diagnosis of hepatic fibrosis.