天冬氨酸转氨酶、γ-谷氨酰基转移酶和胆红素等与肝硬度值的相关性研究

The serum aspartate transaminase, γ-glutamyltransferase and bilirubin level were associated with liver stiffness

目的研究慢性乙型肝炎患者肝功能指标与肝硬度值之间的关系。方法研究对象包括35例慢性乙型肝炎患者,间隔1～33周分别检测瞬时弹性探测仪(Fibro-Scan)肝硬度值,及血清ALT、AST、GGT、ALB、GLO和TBIL等。分析两次肝功能指标值、年龄等与对应肝硬度值的相关性及两次肝功能指标变化值、两次检测间隔时间等与肝硬度变化值之间的相关性。以肝硬度变化值为因变量,以肝功能指标变化值及年龄和两次检测间隔周数等为自变量,进行多元回归分析。结果两次检测的GGT、ALB、TBIL与DBIL水平与肝硬度值之间均存在一定的相关性;年龄、两次检测AST、GGT、GLO、TBIL与DBIL变化值与肝硬度变化值之间,存在一定的相关性(r=0.380、0.503、0.536、0.369、0.341、0.497;P<0.05)。两次检测间隔时间与肝硬度变化值之间没有明显的相关性(P>0.05)。多元回归分析结果:肝硬度变化值=0.4982×GLO变化值+0.4621×DBIL变化值(F=15.108,P<0.001)。结论炎症程度影响肝脏硬度值,但难以通过AST等校正Fibroscan测量值的方式来准确地评估肝纤维化程度。

Objective To study the correlation between liver functions and liver stiffness in patients with chronic hepatitis B （CHB）. Methods Thirty-five patients with CHB were enrolled. The liver stiffness values （measured by Fibroscan）, serum ALT, AST, GGT, ALB, GLO and TBIL were detected twice during an interval of 1-33 weeks. The relationship between values of liver function or age and liver stiffness values, between the changes of twice liver function values or the times of detection intervals and the changes of liver stiffness were investigated. Multivariate regression analysis was carried out, with the liver stiffness changes as the dependent variable, the changes of ALT, AST, GGT, ALB, GLO, TBIL, DBIL, age and the times of detection interval as independent variables. Result The GGT, ALB, TBIL and DBIL levels were correlated with liver stiffness; Age, and the changes of AST, GGT, GLO, TBIL and DBIL were correlated with the changes of liver stiffness （r=0.380, 0.503, 0.536, 0.369, 0.341, 0.497; P＆lt;0.05）. The times of detection interval and the changes of liver stiffness had shown no significant correlation （P ＆gt; 0.05）. Multivariate regression analysis showed： liver stiffness value changes=0.4982 × GLO changes ＋ 0.4621 × DBIL changes （F=15.108, P＆lt;0.001）. Conclusion The degree of inflammation affected the liver stiffness values. However, it is difficult to accurately assess the degree of liver fibrosis by Fibroscan test by corrected AST levels.