免疫球蛋白联合肝功能指标检测在肝衰竭诊断和预后判断中的价值

Value of Immunoglobulin Combined with Liver Function in the Diagnosis and Prognosis of Liver Failure

目的探讨在肝衰竭诊断与预后判断中肝功能指标γ-谷氨酰基转肽酶(GGT)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)与血清免疫球蛋白(Ig)A、IgG、IgM联合检测的应用价值。方法选取本院2018年3月至2019年3月收治的肝衰竭患者96例(观察组),另选取同期健康体检者68名(对照组),用散射比浊法对IgA、IgG、IgM水平进行检测,用比色法对血清GGT、AST、ALT水平进行检测。结果观察组血清GGT、AST、ALT水平相比对照组明显升高(P<0.05)。经logistic回归分析得知,GGT、AST、ALT、IgA、IgG、IgM为肝衰竭的主要危险因素(P<0.05)。各指标联合检测时,受试者有着最大的工作特征曲线下面积(AUC),即0.905。通过开展logistic回归分析,GGT、AST、ALT、IgG、IgA升高为肝衰竭治疗后死亡的主要危险因素(P<0.05),各指标联合检测时,有最大的AUC,即0.900。结论GGT、AST、ALT、IgG、IgA水平升高是诱发肝衰竭及造成较差预后的危险因素,采取肝功能指标与免疫球蛋白联合检测对此病诊断及预后判断有积极的意义与价值。

Objective To explore the application value of combined detection of liver function indicators such as gamma-glutamyl transpeptidase(GGT),aspartic aminotransferase(AST),alanine aminotransferase(ALT)and serum immunoglobulin(Ig)A,IgG and IgM in the diagnosis and prognosis of liver failure.Methods From March 2018 to March 2019,96 cases of liver failure patients(observation group)and another 68 cases(control group)were selected.IgA,IgG and IgM levels were detected by nephelometry,and serum GGT,AST and ALT levels were detected by colorimetry.Results The serum GGT,AST and ALT levels in the observation group were significantly higher than those in the control group(P<0.05).Logistic regression analysis showed that GGT,AST,ALT,IgA,IgG and IgM were the main risk factors for liver failure(P<0.05).When the indicators are combined,the subject had the largest AUC,0.905.Through logistic regression analysis,the increase of GGT,AST,ALT,IgG and IgA was the main risk factors for death after liver failure treatment(P<0.05),and the maximum AUC(0.900)was found in the combined detection of all indicators.Conclusion Elevated levels of GGT,AST,ALT,IgG and IgA are risk factors that induce liver failure and cause poor prognosis.Combined detection of liver function indicators and immunoglobulin is of positive significance and value in the diagnosis and prognosis of this disease.