HBV感染者血清转氨酶与胆碱脂酶、白蛋白、前白蛋白的关系

Relationship between ALT/AST and CHE, ALB, PA in population with HBV

目的探讨乙肝病毒(HBV)感染者血清转氨酶(ALT/AST)与胆碱脂酶(CHE)、前白蛋白(PA)、白蛋白(ALB)的关系,以评价各指标对HBV感染者的诊断价值。方法用全自动生化分析仪检测245例HBV感染者血清ALT、AST、CHE、PA、ALB,根据ALT/AST水平分为ALT/AST正常组、ALT/AST轻度异常组、ALT/AST异常组,对各组之间CHE、ALB、PA进行差异比较,并对各组CHE、ALB、PA与AST/ALT之间做相关分析;根据CHE的水平分为CHE正常组、CHE轻度异常组、CHE异常组,对各组之间ALB、PA进行差异比较,并对各组ALB、PA与CHE之间做相关分析。结果以血清ALT/AST分组,血清CHE、ALB、PA结果ALT/AST正常组大于ALT/AST轻度异常组,差异均有统计学意义(CHE:t=-3.536,P<0.05;ALB:t=-4.343,P<0.05;PA:t=-4.722,P<0.01),血清PA结果ALT/AST轻度异常组大于ALT/AST异常组,差异有统计学意义(t=-2.566,P<0.05),而血清CHE、ALB结果ALT/AST轻度异常组与ALT/AST异常组之间差异均无统计学意义(CHE:t=-1.111,P>0.05,ALB:t=-0.494,P>0.05),血清ALT/AST与CHE、ALB、PA之间均有显著相关性(分别为-0.373、-0.380、-0.442),三组内异常率PA>CHE>ALB;以血清CHE分组,血清ALB、PA结果 CHE正常组大于CHE轻度异常组,差异均有统计学意义(t=8.340,P<0.05;t=4.822,P<0.05),CHE轻度异常组大于CHE异常组,差异均有统计学意义(t=7.302,P<0.05;t=4.941,P>0.05),CHE与ALB、PA之间均有显著相关性(分别为0.825、0.753),三组内异常率为PA>ALB。结论血清肝功能指标与肝损伤指标密切相关;反映肝功能损害程度的血清生化指标是PA>CHE>ALB;对HBV感染者,血清PA可能有早期诊断肝功能损害的价值。

Objective To explore the relationship between ALT/AST and CHE, ALB and PA in population with HBV, and to evaluate their diagnostic values. Methods The levels of ALT, AST, CHE, ALB and PA in 245 HBV infection serums were detected by automatic biochemical analyzer. The data obtained were divided into three groups according to the result of ALT/AST： ALT/AST normal group, ALT/AST mild abnormal group and ALT/AST abnormal group. The differences of CHE, ALB and PA between those groups were compared and the correlations among CHE,ALB, PA and ALT/AST were analyzed. The data were divided into three groups according to the result of CHE： CHE normal group, CHE mild abnormal group and CHE abnormal group. Results When grouped by the levels of ALT/AST, the levels of CHE, ALB and PA in ALT/AST normal group were significantly higher than that in ALT/AST mild abnormal group（CHE： t=-3.536, P〈0.05, ALB： t=-4.343, P〈0.05, PA： t=-4.722, P〈0.01）. The level of PA in the transaminase mild abnormal group was significantly higher than that in ALT/AST abnormal group（t=-2.566, P〈0.05）.However, the levels of CHE and ALB in ALT/AST mild abnormal group and in t ALT/AST abnormal group had no significant difference（CHE： t=-1.111, P〉0.05, ALB： t=-0.494, P〈0.05）. The correlations between CHE, ALB, PA and ALT/AST were negative（were-0.373,-0.380 and-0.442, respectively）. The abnormal rates of three groups were PA〉CHE〉ALB. When grouped by the levels of CHE, the levels of ALB and PA in CHE normal group were significantly higher than those in CHE mild abnormal group（t=8.340, P〈0.05, t=4.822, P〈0.05）, and the levels of ALB and PA in CHE mild abnormal group were significantly higher than those in CHE abnormal group（t=7.302, P〈0.05, t=4.941, P〉0.05）. The correlations between ALB, PA and CHE were positive（were 0.825 and 0.753, respectively）. The abnormal rates of three groups were PA〉ALB. Conclusion Liver function indices were closely related to liver injury indices.Among PA, CHE and ALB, PA is the best one and ALB is the third one in reflecting the extent of liver damage. Serum PA could predict early liver dysfunction in patients with hepatitis B.