肝病患者肝功能检测指标和甲胎蛋白结果比较

Comparison of the results in the detection of alp ha fetoprotein and liver function in patients with liver disease

目的探讨不同类型肝病患者的甲胎蛋白(AFP)及肝功能检测结果之间的关系。方法选择2013年7月至2014年1月我院门诊及住院病例380例,分为3组,其中慢性乙型肝炎组200例,肝硬化组100例,肝癌组80例,选取健康对照组50名。检测4组患者血清AFP、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、γ-谷氨酰转肽酶(GGT)水平,采用独立样本的t检验,两两比较慢性乙型肝炎组,肝硬化组,肝癌组及对照组间参数的关系。结果对照组与慢性乙型肝炎组相比,各项指标差异均有统计学意义(P<0.05);对照组与肝硬化组相比,AST,GGT,AFP差异均有统计学意义(P<0.05);对照组与肝癌组相比,各项指标差异均有统计学意义(P<0.05);慢性乙型肝炎组与肝硬化组相比,AFP、ALT、GGT差异均有统计学意义(P<0.05);慢性乙型肝炎组与肝癌组相比,AST、AFP、GGT差异均有统计学意义(P<0.05);肝硬化组与肝癌组相比,AFP、ALT、GGT差异均有统计学意义(P<0.05)。慢性乙型肝炎组AST/ALT比值<1,肝硬化组跟肝癌组AST/ALT比值>1。对照组、慢性乙型肝炎组、肝硬化组及肝癌组的AFP升高百分率分别为0%、28%、33%、75%。结论与对照组相比,慢性乙型肝炎、肝硬化、肝癌患者血中AFP、ALT、AST、GGT水平均明显增高,AFP、AST、GGT在肝癌组表达最高,其次是肝硬化组,慢性乙型肝炎组。ALT在肝癌组最高,慢性乙型肝炎组其次。慢性乙型肝炎组AST/ALT比值<1,肝硬化组跟肝癌组AST/ALT比值>1,其比值对肝病的诊断、治疗及预后有较好的指导作用。

Objective To explore the relationship of alpha fetoprotein （AFP）, aspartate aminotransferase （AST）, alanine aminotransferase （ALT） and γ-Glutamyhransferase （GGT） among different types of liver diseases. Methods Three hundred and eighty eases in our hospital from July 2013 to January 2014 were divided into three groups, including 200 cases of chronic hepatitis, 100 cases of liver cirrhosis, 80 cases of liver cancer. Fifty cases of normal people were in control group. The levels of AFP, AST, ALT and GGT in those group were examined. Results The levels of AFP, AST, ALT and GGT in chronic hepatitis were significantly unregulated than the normal control group （P〈0.05）; The levels of AFP, AST and GGT in the liver cirrhosis were significantly higher than those in the normal control group （P〈0.05）. The levels of AFP, AST, ALT and GGT in the liver cancer was significantly unregulated than those of in the normal control group （P〈0.05）. There were statistically significant differences in AFP, ALT and GGT between chronic hepatitis group and liver cirrhosis. There were statistically significant differences in AST, AFP and GGT between chronic hepatitis group and the liver cancer group （P〈0.05）. Statistically significant differences were found in AFP, ALT, GGT between the liver cirrhosis group and the liver cancer group （P〈0.05）. The AST/ALT ratio of chronic hepatitis 〈1, and liver cirrhosis group and liver cancer group 〉1. The positive examine rates of AFP in normal control group, chronic hepatitis, liver cirrhosis group, liver cancer group were 0%, 28%, 33%, 75% respectively. Conclusion The levels of AFP, AST, ALT and GGT in liver diseases group were significantly higher than those in the normal group, moreover, the liver cancer group has the highest levels of AFP, AST and GGT, followed by the live cirrhosis group and the chronic hepatitis group. The liver cancer group also had the highest level of ALT, followed by chronic hepatitis group. The AST/ALT ratio of chronic hepatitis 〈1, and liver cirrhosis group and liver cancer group 〉1. Those results not only reflect the severity of liver diseases, but also provid a valuable basis for the diagnosis of the liver diseases, efficacy observation, disease monitoring and prognosis.