多项生化指标检测在肝硬化辅助诊断中的应用价值探讨

Application Value of Multiple Biochemical Indexes in Auxiliary Diagnosis of Liver Cirrhosis

目的:探讨血清腺苷脱氨酶(ADA)、总胆汁酸(TBA)、视黄醇结合蛋白(RBP)和胆碱酯酶(ChE)检测在肝硬化(LC)辅助诊断中的应用价值。方法:对156例某院明确诊断的病毒性LC患者(疾病组)和150例同期健康体检的健康体检者(对照组)的血清样本进行ADA、TBA、RBP和ChE检测,比较各检测指标水平的差异以及单项与联合检测的阳性检出率。结果:疾病组ADA和TBA检测水平显著高于对照组,RBP和ChE检测水平显著低于对照组(P<0.05)。B级ADA和TBA检测水平高于A级,RBP和ChE检测水平低于A级(P<0.05);C级ADA和TBA检测水平显著高于B级,RBP和ChE检测显著水平低于B级(P<0.01);A级中ADA、TBA、RBP和ChE单项阳性检出率和联合检测的阳性检出率均高于对照组(P<0.05);A级中联合检测的阳性检出率明显高于单项阳性检出率(P<0.05)。结论:ADA、TBA、RBP和ChE与LC患者肝细胞损害密切相关,可作为LC肝实质损伤程度的重要反映指标,联检有助于提高早期LC检出率,对LC的早期辅助诊断、病情严重程度等方面有着重要的应用价值。

Objective：To investigate the value of serum adenosine deaminase（ADA）,total bile acid（TBA）,retinol binding protein（RBP）and cholinesterase（ChE）in the diagnosis of liver cirrhosis.Methods：ADA,TBA,RBP,and ChE were detected in 156 cases of viral LC patients（disease group）and 150 healthy physical examination persons（control group）in a hospital during the same period.The difference of each index level and the positive rate of single test and joint test were compared.Results：The levels of ADA and TBA in the disease group were significantly higher than those in the control group.The levels of ChE and ADA in the disease group were significantly lower than those in the control group（P〈0.05）.The detection levels of ADA and TBA in grade B were higher than those in grade A,and the levels of RBP and ChE were lower than those in grade A（P〈0.05）.The detection levels of ADA and TBA in grade C were significantly higher than those of grade B,and the levels of RBP and ChE were significantly lower than those of grade B（P〈0.01）.The positive detection rates of ADA,TBA,RBP and ChE in grade A were higher than those in the control group（P〈0.05）.The positive rate of combined detection in grade A was significantly higher than that in single detection（P〈0.05）.Conclusion：ADA,TBA,RBP and ChE are closely related to the LC patients with liver cell damage,which is helpful to improve the detection rate of early LC,and has important application value in the early diagnosis of LC and the severity of the disease.