4项生化指标检测在肝硬化与病毒性肝炎诊断中应用研究

Application of four biochemical indexes in diagnosis of cirrhosis and viral hepatitis

目的探讨总胆红素(TBIL)、白蛋白(ALB)、总胆汁酸(TBA)、胆碱酯酶(ChE)4项生化指标检测在肝硬化与病毒性肝炎诊断中的应用效果。方法选取本院2017年6月—2018年6月肝病患者80例,其中肝硬化患者40例,病毒性肝炎患者40例,选取同期健康人员40名作对照组,比较各组4项生化指标水平及阳性检出率。结果肝硬化组TBIL、TBA水平显著高于病毒性肝炎组及对照组,ALB、ChE水平显著低于病毒性肝炎组及对照组,差异有统计学意义(P<0.05);病毒性肝炎组TBIL、TBA水平显著高于对照组,ALB、ChE水平显著低于对照组,差异有统计学意义(P<0.05);肝硬化组TBIL、TBA、ALB、ChE阳性检出率显著高于病毒性肝炎组,差异有统计学意义(P<0.05);经ROC曲线分析证实,在TBIL临界值为20.830μmol/L时,可获得最为理想的特异度及灵敏度,分别为57.5%、85.0%;在ALB临界值为22.625 g/L时,可获得最为理想的特异度及灵敏度,分别为82.5%、87.5%;在TBA临界值为21.515μmol/L时,可获得最为理想的特异度及灵敏度,分别为62.5%、87.5%;在ChE临界值为2710.460 U/L时,可获得最为理想的特异度及灵敏度,分别为82.5%、87.5%。结论TBIL、ALB、TBA、ChE水平与患者肝损伤程度具有较大的相关性,可作为临床诊断肝硬化的参考依据。

Objective To investigate the application of four biochemical indexes[total bilirubin(TBIL),albumin(ALB),total bile acid(TBA),and cholinesterase(ChE)]in the diagnosis of cirrhosis and viral hepatitis.Methods From June 2017 to June 2018,80 patients with liver diseases were selected,including 40 patients with cirrhosis(a cirrhotic group)and 40 patients with viral hepatitis(a viral hepatitis group),and in addition,40 healthy people were selected as controls(a control group)during the same period.The levels and the positive detection rates of four biochemical indexes above-mentioned were detected and compared among 3 groups.Results The levels of TBIL and TBA in the cirrhotic group were significantly higher than those in the viral hepatitis group and the control group,the levels of ALB and ChE were significantly lower than those in the viral hepatitis group and the control group(P<0.05),and the levels of TBIL and TBA in the viral hepatitis group were significantly higher than those in the control group(P<0.05).The positive rates of TBIL,TBA,ALB and ChE in the cirrhotic group were significantly higher than those in the virus hepatitis group,and the difference was statistically significant(P<0.05).The most desirable specificity and sensitivity were 57.5% and 85.0% respectively at TBIL critical value of 20.830μmol/L;were 82.5% and 87.5% respectively at ALB critical value of 22.625 g/L;were 62.5% and 87.5% respectively at TBA critical value of 21.515μmol/L;were 82.5% and 87.5%,respectively at ChE critical value of 2710.460 U/L.Conclusion TBIL,ALB,TBA and ChE have great correlation with the degree of liver injury,which can be used as references for the clinical diagnosis of cirrhosis.