HCV-RNA、抗-HCV、肝功能指标对丙型肝炎的临床诊断价值

Clinical diagnosis value of HCV RNA,anti HCV and liver function indexes in hepatitis C

目的分析丙型肝炎病毒抗体(抗-HCV)阳性患者丙型肝炎病毒核酸RNA(HCV-RNA)载量、肝功能指标在丙型肝炎诊断中的价值。方法选取893例抗-HCV>1 S/CO的患者,检测其HCV-RNA和丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰基转肽酶(GGT)及α-L-岩藻苷酶(AFU)水平。采用受试者工作特征曲线(ROC曲线)分析各项指标诊断丙型肝炎的效能。结果抗-HCV、ALT、AST诊断丙型肝炎的ROC曲线下面积分别为0.884、0.760、0.760。抗-HCV截断值为10.26 S/CO时,其诊断丙型肝炎的灵敏度为95.7%,特异度为75.6%;ALT的灵敏度和特异度分别为68.6%、73.3%,AST的灵敏度和特异度分别为77.7%、65.3%。抗-HCV≥10.26 S/CO组HCV-RNA、肝功能指标均高于抗-HCV<10.26 S/CO组,差异均有统计学意义(P<0.05)。HCV-RNA阳性组抗-HCV、肝功能指标均高于HCV-RNA阴性组,差异均有统计学意义(P<0.05)。抗-HCV与HCV-RNA载量等级的相关性最高(r=0.632,P<0.05)。结论抗-HCV≥10.26 S/CO时,结合HCV-RNA、ALT、AST检测对丙型肝炎具有较准确和全面的诊断价值。

Objective To analyze the value of hepatitis C virus RNA(HCV-RNA)load and liver function indexes in the diagnosis of hepatitis C in patients with hepatitis C antibody(anti-HCV)positive.Methods A total of 893 cases with anti-HCV>1 S/CO were collected,and HCV-RNA and alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-Glutamyl transpeptidase(GGT)andα-L-Fucosidase(AFU)were detected.Receiver operating characteristic curve(ROC curve)was used to analyze the effectiveness of various indicators in diagnosis of hepatitis C.Results The area under the curve for the diagnosis of hepatitis C by anti-HCV,ALT,AST were 0.884,0.760,0.760.When the cut off value of anti-HCV was 10.26 S/CO,the sensitivity for diagnosing hepatitis C was 95.7%and the specificity was 75.6%,respectively,the sensitivity and the specificity of ALT were 68.6%and 73.3%,respectively,while the sensitivity and the specificity of AST were 77.7%and 65.3%,respectively.The HCV-RNA and liver function indexes of anti-HCV≥10.26 S/CO group were higher than those of anti-HCV<10.26 S/CO group,and the differences were statistically significant(P<0.05).The anti-HCV and liver function indexes of HCV-RNA positive group were higher than those of HCV-RNA negative group,and the differences were statistically significant(P<0.05).Anti-HCV had the highest correlation with HCV-RNA load level(r=0.632,P<0.05).Conclusion When anti-HCV was≥10.26 S/CO,the combination detection of HCV-RNA,ALT and AST has a more accurate and comprehensive diagnostic value for hepatitis C.