重型肝炎患者血清甲胎蛋白水平与预后的关系

Relationship between Serum Alpha-fetoprotein Levels and Prognosis in Patients with Severe Hepatitis

目的探讨重型肝炎患者血清甲胎蛋白(alpha-fetoprotein,AFP)水平与预后的关系。方法将280例重型肝炎患者按AFP值大小分为3组:A组95例(AFP<20μg.L-1)、B组(AFP 20～600μg.L-1)100例和C组(AFP>600μg.L-1)85例。使用放射免疫仪、采用化学发光法检测AFP水平。对3组患者的临床疗效进行评定。结果 B组有效率较A组高,但差异无统计学意义(34.0%vs 20.0%,P>0.05)。A、B 2组患者有效率与C组比较差异均有统计学意义(20.0%、34.0%vs 77.6%,均P<0.01)。A、B 2组治疗后1个月血清AFP水平均明显低于C组,差异均有统计学意义[(212.80±27.00)、(231.60±23.04)μg.L-1 vs(360.71±25.80)μg.L-1,均P<0.01)]。A、B、C 3组患者血清AFP水平与预后均呈正相关(r=0.33、0.40、0.87,P<0.05或P<0.01)。结论血清中AFP的高低可以作为判断重型肝炎预后的指标。

Objective To explore the relationship between serum alpha-fetoprotein（AFP） levels and prognosis in patients with severe hepatitis.Methods According to the AFP values,280 patients with severe hepatitis were divided into three groups：group A（95 patients,AFP20 μg·L-1）,group B（100 patients,AFP 20-600 μg·L-1） and group C（85 patients,AFP600 μg·L-1）.The levels of AFP were detected by radioimmunoassay and chemical method shine.The curative effects were evaluated in the three groups.Results The effective rate in group B was higher than that in group A,but the difference was not statistically significant（34.0% vs 20.0%,P0.05）.Compared with group C,the effective rate and serum AFP levels significantly decreased in group A and B[the effective rate：20.0% and 34.0% vs 77.6%,both P0.01;AFP levels：（212.80±27.00） μg·L-1and（231.60±23.04）μg·L-1 vs（360.71±25.80）μg·L-1,both P0.01）].Serum AFP levels in group A,B and C were positively correlated with prognosis（r= 0.33,0.40 and 0.87,respectively;P0.05 or P0.01）.Conclusion The levels of serum AFP can be used as indicators for determining the prognosis of severe hepatitis.