联合检测LAP、ALT、γ-GT对甲状腺功能亢进肝损害诊断价值的探讨

Detection of LAP,ALT,γ-GT in Patients with Hyperthyroidism

目的探讨血清LAP、ALT联合γ-GT对甲状腺功能亢进合并肝损害的诊断价值。方法选取2015年10月至2017年11月我院门诊及住院收治的188例甲亢患者。根据检查结果分为甲亢肝损害组(n=98)和甲亢无肝损害组(n=90)。选取同期健康体检者100例作为对照组。比较各组间血清FT_3、FT_4、TSH、LAP、ALT、γ-GT水平、相关性分析及诊断学指标。结果甲亢肝损害组和甲亢无肝损害组血清FT_3、FT_4水平显著高于对照组,TSH显著低于对照组(P<0.05),甲亢肝损害组血清FT_3、FT_4水平显著高于甲亢无肝损害组(P<0.05),而两组TSH水平无统计学差异(P>0.05)。甲亢肝损害组和甲亢无肝损害组血清LAP、ALT、γ-GT水平显著高于对照组,甲亢肝损害组血清LAP、ALT、γ-GT水平显著高于甲亢无肝损害组(P<0.05)。经过Spearson相关性分析,FT_3、FT_4与肝功能指标(LAP、ALT、γ-GT)均呈正相关关系。三项指标联合检测的灵敏度(90.0%)、特异性(95.8%)及准确度(92.9%)明显高于任一单项指标检测结果(P<0.05)。结论甲亢肝害患者LAP、ALT、γ-GT水平异常升高与甲状腺激素有密切关系,其联合检测有利于甲亢肝害伤的早期诊断。

Objective To investigate the diagnostic value of serum LAP, ALT combined with γ-GT in hyperthyroidism complicated with liver injury. Methods 188 patients with hyperthyroidism admitted to our hospital from October 2015 to November 2017 were selected. According to the results of the examination, they were divided into hyperthyroid liver damage group （n = 98 ） and hyperthyroid non-liver damage group （n = 90）. 100 healthy subjects were selected as control group at the same period. The levels of serum FT3 ,FT4, TSH, LAP, ALT, and γ-GT in each group were compared, and the correlation analysis and diagnostic indexes were performed. Results The levels of serum FT3 , FT4 in hyperthyroid liver damage group and non-liver damage group were significantly higher than those in control group, but TSH was lower than that in control group （ P 〈 0.05 ）. The levels of serum PT3, PT4 in hyperthyroid liver damage group were significantly higher than those in nonliver damage group （ P 〈 0.05 ）, but TSH between two groups had no difference （ P 〉 0.05 ）. The levels of serum LAP, ALT, and γ- GT in hyperthyroid liver damage group and hyperthyroid non- liver damage group were significantly higher than those in control group, and the levels of serum LAP, ALT,γ-GT in hyperthyroid liver damage group were significantly higher than those in non-hyperthyroid damage lesion group （ P 〈 0.05 ）. After Spearson correlation analysis, FT3 and FT4 were positively correlated with liver function indicators （ LAP, ALT, γ- GT ）. The sensitivity （ 90 % ）, specificity （ 95.8 % ） and accuracy （ 92.9 % ） of the combined detection of three indicators were significantly higher than those of any single index （ P 〈 0.05 ）. Conclusion Abnormally elevated levels of LAP, ALT, and ,γ- GT in patients with hyperthyroidism liver injury are closely related to thyroid hormones, and the combined detection is beneficial to the early diagnosis of hyperthyroidism liver injury.