缺糖基转铁蛋白在酒精性肝病中的诊断价值

Diagnostic value of carbohydrate deficient transferring for alcoholic liver disease

目的研究酒精性肝病(ALD)患者血清中缺糖基转铁蛋白百分含量(%CDT),并与肿瘤坏死因子-α(TNF-α)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)、红细胞平均体积(MCV)、平均血红蛋白浓度(MCHC)、红细胞平均血红蛋白含量(MCH)进行比较,评价其对ALD的诊断价值。方法选择ALD患者43例,分为酒精性脂肪肝组、酒精性肝炎组、酒精性肝纤维化组、酒精性肝硬化组共4组。非酒精性肝病患者(NALD组)39例,对照组40例,运用免疫散射比浊法测定%CDT;ELISA法测定TNF-α;速率法测定ALT、AST、GGT;全自动血细胞分析仪测定MCV、MCHC、MCH。结果 4组的%CDT、TNF-α、GGT、MCV、MCHC、MCH明显高于对照组(P<0.05);4组的%CDT、TNF-α、GGT、MCV、MCHC、MCH明显高于NAFLD组,ALT、AST明显低于NAFLD组,差异有统计学意义(P<0.05)。NAFLD组TNF-α、GGT、ALT、AST、MCV明显高于对照组,差异有统计学意义(P<0.05)。%CDT诊断ALD的敏感度为86.0%,特异度为90.0%。TNF-α诊断ALD的敏感度为76.7%,特异度为80%。%CDT、TNF-α和GGT联合检测在ALD组诊断敏感度提高为95.3%,特异度为97.5%。结论 %CDT在诊断ALD中具有重要的作用,其价值优于TNF-α、ALT、AST、GGT、MCV、MCHC、MCH。联合检测%CDT、TNF-α和GGT,对ALD的诊断及临床治疗具有重要的意义。

Objective To study the alcoholic liver disease（ALD）in the serum of carbohydrate-deficient transferrin percent content（%CDT）,and compare with tumor necrosis factor alpha（TNF-α）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,gamma glutamyl transpeptidase（GGT）,mean corpuscular volume（MCV）,mean corpuscular hemoglobin concentration（MCHC）,mean corpuscular hemoglobin（MCH）,evaluate its value in the diagnosis of ALD.Methods 43cases of ALD were divided into 4groups,alcoholic fatty liver group,alcoholic hepatitis group,alcoholic liver fibrosis group,alcoholic cirrhosis group.Nonalcoholic fatty liver disease patients（NALD group）39cases,40cases in the control group,using immune scattering method to determine the%CDT than polluted;ELISA method to determine the TNF-α;Rate method to determine the ALT,AST,GGT;Automatic blood cells analyzer MCV,MCHC,MCH determination.Results %CDT,TNF-α,GGT,MCV,MCHC,MCH of 4groups were significantly higher than that of the control group（P〈0.05）;%CDT,TNF-α,GGT,MCV,MCHC,MCH of 4groups were higher than that in NAFLD group.ALT,AST were significantly lower than those in NAFLD group,the difference was statistically significant（P〈0.05）.TNF-α,GGT,ALT,AST,MCV of NAFLD group were higher than those in the control group,the difference was statistically significant（P〈0.05）.%CDT diagnosis of ALD the sensitivity was 86%,specificity was 90%.TNF-αdiagnosis for 76.7% of ALD sensitivity,the specific degrees of 80%.% CDT,TNF-αand GGT united detection sensitivity in ALD group increased by 95.3%,the specific degrees of 97.5%.Conclusion % CDT in the diagnosis of ALD plays an important role,its value is better than the TNF-α,ALT,AST,GGT,MCV,MCHC,MCH.united detection%CDT,TNF-αand GGT,to the diagnosis and clinical treatment ALD is of great significance.