25羟维生素D在原发性胆汁性肝硬化中的诊断价值

Significance of serum 25(OH)-vitamin D in its diagnostic value of primary biliary cirrhosis

目的:初步探讨25-羟维生素D[25-(OH)D]在原发性胆汁性肝硬化(PBC)中的诊断价值。方法:收集宁夏医科大学总院2013年12月到2015年6月期间住院的44例确诊为PBC的患者,随机收集确诊为乙肝肝硬化患者41例及我院体检健康人群110例作为对照组,分析患者组和对照组的生化指标及血清25-羟维生素D含量,并对PBC患者血清中25-羟维生素D绘制ROC曲线进行统计分析。结果:生化指标TBIL、DBIL、IBIL、GLB、AST、ALT、ALP、γ-GT在PBC组中均显著高于正常对照组和乙肝肝硬化组,差异有统计学意义。25-羟维生素D含量在PBC患者中显著低于正常对照组和乙肝肝硬化组,差异有统计学意义。PBC患者血清中25-羟维生素D绘制ROC曲线下的面积(AUC)为0.926,筛选其最佳截断点:当25-(OH)D=17.275 ng/ml时,敏感性为92.8%,特异性为84.1%。结论:25羟维生素D在PBC患者血清中的含量明显下降,对PBC的诊断具有一定的价值,25-(OH)D=17.275 ng/ml可能是一个诊断的界值。

Objective： To investigate the significance of 25 （OH）-vitamin D in its diagnostic value of primary biliary cirrhosis. Methods ：44 cases with PBC ,41 cases with Hepatitis B cirrhosis and 110 normal people as control group were all analyzed biochemical results and significance of serum 25 （ OH ） -vitamin D. We Used receiver operator characteristic curve （ ROC ） to analyze serum 25 （OH）-vitamin D in its diagnostic value of primary biliary cirrhosis. Results：Biochemical results of TBIL, DBIL, IBIL, GLB, AST, ALT, ALP, γ-GT were higher in PBC than that in normal people and Hepatitis B cirrhosis. While the serum 25 （OH）-vitamin D of PBC was much more lower than that in normal and people and Hepatitis B cirrhosis. The difference between them were statistical difference（ P〈0.05 ）. The area under the ROC curve of PBC was 0. 926, it showed serum 25 （ OH ） -vitamin D diagnosis for PBC had quite value. When the cut-off level of serum 25 （OH）-vitamin D was 17. 275 ng/ml, the sensitivity for the diagnosis was 92. 8% , the respectively was 84. 1%. Conclusion：Serum 25 （OH）-vitamin D diagnosis for PBC has quite value, the cut-off level of serum 25 （OH）- vitamin D is 17. 275 ng/ml.