血清总胆汁酸与丙氨酸氨基转移酶联合测定对肝胆疾病患者的临床价值分析

Clinical value analysis on serum TBA and ALT combined determination for hepatobiliary patients′

目的建立血清总胆汁酸(TBA)和血清丙氨酸氨基转移酶(ALT)联合测定模式,探讨该模式对肝胆患者的临床应用价值。方法采用Hitachi 7600-020全自动生化分析仪(日本日立公司)分别对223例肝胆疾病患者和60例健康对照者血清TBA和ALT进行联合检测。结果各种肝胆疾病患者血清TBA和与健康对照组相比均明显升高:TBA的阳性检出率在急性肝炎、慢性肝炎、肝癌、肝硬化分别为100.0%、89.1%、88.4%、84.0%和75.9%。ALT的阳性检出率在急性肝炎、慢性肝炎、胆道疾病、肝癌、肝硬化分别为100.0%、81.8%、73.9%、36.0%和37.9%。ALT在各种肝胆疾病患者中均有不同程度的升高(均P<0.01)。血清TBA在急性肝炎、慢性肝炎和胆道疾病中有明显升高(均P<0.01),其阳性检出率均在80%以上。急性肝炎时,TBA和ALT阳性检出率都达到100.0%,但两者在肝癌和肝硬化患者的阳性检出率上差异均有统计学意义(均P<0.05),胆道疾病中也有较大差异(P<0.05)。结论 TBA与ALT都是肝胆疾病的重要而且灵敏的指标,但是两者特异性、敏感性在不同肝胆疾病过程中并不一致,各有优劣,因此TBA与ALT联合测定在监测各种肝胆疾病中的有着现实的临床意义。

Objective To establish the combined determination mode for serum total bile acid（TBA） and ala- nine aminotransferase（ALT） and to discuss its clinical value for the hepatobitiary patients. Methods The Hitachi 7600-020 fully automatic biochemical analyzer was adopted to conduct the combined detection of serum TEA and ALT in 223 cases of hepatobiliary diseases and 60 healthy individuals. Results Serum TBA in various hepatobiliary diseases was significantly increased compared with the control group. The TEA positive detection rate in acute hepati- tis,chronic hepatitis,liver cancer and liver cirrhosis were 100.0% ,89.1% ,88.4% ,84.0% and 75.9% respectively. The ALT positive detection rate in acute hepatitis, chronic hepatitis, gall disease, liver cancer, liver cirrhosis were 100.0% ,81.8% ,73.9% ,36.0% and 37.9% respectively. ALT was increased to different degrees in varying gall dis- eases（P〈0.01）. Serum TBA in acute hepatitis, chronic hepatitis and gall disease was significantly increased（P〈0.01） ,with the positive detection rate of more than 80%. The positive detection rate of TEA and ALT reached to 100.0% in acute hepatitis,but which in liver cancer and liver cirrhosis had statistical difference（P〈0.05） and which in gall diseases also had greater difference（P〈0.05）. Conclusion TEA and ALT are the important and sensitive in- dicators for hepatobiliary diseases,but their specificity and sensitivity are not consistent in different hepatobiliary dis- ease processes with different advantages and disadvantages. Therefore, the TBA and ALT combined determination has realistic clinical value for monitering various hepatobiliary diseases.