肝纤维化指标联合AFP、GGT检测在肝病诊断中的应用价值

Application value of liver fibrosis indexes combined with AFP and GGT in the diagnosis of liver diseases

目的探讨肝纤维化指标[Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、层黏连蛋白(LN)、透明质酸(HA)、甘胆酸(CG)]、甲胎蛋白(AFP)与γ-谷氨酰转肽酶(GGT)在肝病诊断中的应用价值。方法选取2017年7月～2018年6月于湖南省郴州市第一人民医院(以下简称"我院")就诊的慢性乙型肝炎病毒(HBV)携带者90例(慢性HBV携带组)、肝硬化患者66例(肝硬化组)和乙肝相关性肝癌患者52例(乙肝相关性肝癌组),选取我院同期健康体检者60例(健康对照组),分别用全自动化学发光分析仪和生化分析仪检测各组肝纤维化指标PCⅢ、Ⅳ-C、LN、HA、CG及AFP与GGT。结果三组患者PCⅢ、Ⅳ-C、HA、CG与AFP均高于健康对照组,差异有高度统计学意义(P<0.01);肝硬化组和乙肝相关性肝癌患者组LN、GGT均高于健康对照组,差异有统计学意义(P<0.05);慢性HBV携带者组的LN、GGT与健康对照组比较,差异无统计学意义(P>0.05);HA、CG、AFP在各组间比较,差异有统计学意义(P<0.05)。结论肝纤维化指标PCⅢ、Ⅳ-C、LN、HA、CG、GGT与AFP在肝病诊断中具有较大应用价值,对指导临床治疗具有重要价值。

Objectives To discussion of liver fibrosis index [Ⅲ type collagen(PCⅢ), collagen type Ⅳ before(Ⅳ-C),laminin(LN), hyaluronic acid(HA), gansu cholic acid(CG)], alpha fetal protein(AFP) and γ-glutamyl transpeptidase(GGT) in the diagnosis of liver disease. Methods From July 2017 to June 2018, in Chenzhou NO.1 People′s Hospital of Hunan Province("our hospital" for short), 90 cases of chronic HBV(carry HBV group), 66 patients with cirrhosis of the liver(cirrhosis group) and 52 patients with hepatitis B related liver cancer(HBV-related liver cancer group), 60 cases(healthy control group) health physical examination were selected from the same period. The liver fibrosis indexes PCⅢ,Ⅳ-C, LN and HA, CG and AFP and GGT of each groups were detected by automatic chemiluminescence analyzer and biochemical analyzer respectively. Results PCⅢ,Ⅳ-C, HA, CG and AFP in the three groups were all higher than those in the healthy control group, and the difference were highly statistically significant(P < 0.01). LN and GGT of liver cirrhosis group and HBV-related liver cancer group were higher than that of healthy control group, and the difference were statistically significant(P < 0.05). There was no significant difference in LN and GGT between the chronic HBV carrier group and the healthy control group(P > 0.05). HA, CG and AFP were compared among the groups, and the difference were statistically significant(P < 0.05). Conclusion Liver fibrosis indicators PCⅢ,Ⅳ-C, LN, HA, CG,GGT and AFP have great application value in the diagnosis of liver disease, and have important value in guiding clinical treatment.