血清Hs-CRP联合肝硬度检查在老年肝硬化合并肝癌患者中的诊断价值

Changes of serum Hs-CRP and liver stiffness in elderly patients with liver cirrhosis and hepatocellular carcinoma

目的探讨血清高敏C反应蛋白(Hs-CRP)联合肝硬度检查(LSM)对老年肝硬化合并肝癌患者的诊断效果。方法将80例老年乙肝肝硬化患者按照疾病类型分为肝硬化组(46例)与肝硬化合并肝癌组(34例),选择同时期内40例老年健康体检者作为对照组,对比3组患者的血清Hs-CRP水平与LSM值。结果肝癌组与肝硬化组患者Hs-CRP水平与LSM值显著高于对照组,肝癌组患者Hs-CRP水平与LSM值显著高于肝硬化组,差异具有统计学意义(P<0.01);当LSM值≥27.6 k Pa时,肝癌组患者的Hs-CRP的阳性率为66.7%(18/27),而肝硬化组患者的Hs-CRP的阳性率为46.7%(14/30),差异无统计学意义(P>0.05)。甲胎蛋白阳性与阴性患者之间的Hs-CRP水平与LSM值差异无统计学意义(P>0.05)。结论老年乙肝肝硬化合并肝癌患者的血清HsCRP水平与LSM值显著高于肝硬化患者,对乙肝肝硬化合并肝癌具有一定的诊断意义。

Objective To explore the diagnosis value of serum high-sensitivity C-reactive protein （Hs-CRP） combined with hepatic stiffness measurement （LSM） on liver cirrhosis complicated with hepatocellular carcinoma in elderly patients. Methods Eighty elderly patients with hepatitis B liver cirrhosis were divided into cirrhosis group （46 cases） and hepatic carcinoma group （34 cases）. Serum levels of hs-CRP and liver stiffness value were detected and compared between the two groups. Results Levels of hs-CRP and LSM in hepatic carcinoma group and cirrhosis group were significantly higher than those in the control group. When the level of LSM was ≥27. 6 kPa, the positive rate of hs-CRP in hepatic carcinoma group was 66. 7% （ 18/27）, compared with 46.7% （14/30） in cirrhosis group（P〉0. 05）. There was no significant difference in the levels of Hs-CRP and LSM value between positive and negative alpha group （ P〉 0.05 ）. Conclusions The level of serum Hs-CRP and LSM in the elderly patients with hepatitis B cirrhosis combined with liver cancer are significantly higher than those in patients with cirrhosis, which has a certain clinical significance.