血清胆碱酯酶、胆汁酸和总胆红素联合检测在肝硬化和病毒性肝炎中的诊断价值

Diagnostic Value of Combined Detection of Serum Cholinesterase,Bile Acid and Total Bilirubin in Cirrhosis and Viral Hepatitis

目的研究血清胆碱酯酶(ChE)、胆汁酸(TBA)、总胆红素(TBIL)联合检测在肝硬化和病毒性肝炎中的诊断价值。方法选取2020年4月-2022年4月我院诊治的43例肝硬化(观察A组)患者和43例病毒性肝炎(观察B组)患者为研究对象,并选取同期在我院体检健康者43例为对照组,均进行血清ChE、TBA、TBIL检测,比较三组血清ChE、TBA、TBIL水平;观察B组和观察A组以上指标阳性检出率;观察A组不同肝功能分级患者以上指标水平以及不同指标对肝硬化和病毒性肝炎的诊断效能(敏感度、特异度)。结果观察A组、观察B组ChE均低于对照组,TBA、TBIL均高于对照组(P<0.05),且观察A组ChE低于观察B组,TBA、TBIL均高于观察B组(P<0.05);观察A组血清ChE、TBA、TBIL阳性率均高于观察B组(P<0.05);观察A组Child-pugh C级患者ChE低于A级、B级患者,TBA、TBIL均高于A级、B级患者(P<0.05),且B级ChE低于A级患者,TBA、TBIL均高于A级(P<0.05);ChE+TBA+TBIL联合检测诊断肝硬化和病毒性肝炎的敏感度、特异度均高于ChE、TBA、TBIL单独检测(P<0.05)。结论病毒性肝炎和肝硬化患者血清ChE、TBA、TBIL水平存在差异,且ChE、TBA、TBIL联合检测可提高肝硬化和病毒性肝炎诊断效能,并且可一定程度判定肝硬化患者肝功能损伤程度,为临床诊治提供可靠参考依据。

Objective To study the diagnostic value of combined detection of serum cholinesterase(ChE),bile acid(TBA)and total bilirubin(TBIL)in cirrhosis and viral hepatitis.Methods Forty-three patients with cirrhosis(observation group A)and 43 patients with viral hepatitis(observation group B)diagnosed and treated in our hospital from April 2020 to April 2022 were selected as the research objects,and 43 healthy people who underwent physical examination in our hospital during the same period were selected as the control group.Serum ChE,TBA and TBIL were detected,and the levels of serum ChE,TBA and TBIL were compared among the three groups.The positive detection rates of the above indexes in group B and group A were observed.The levels of the above indicators in patients with different liver function grades in group A and the diagnostic efficacy(sensitivity and specificity)of different indicators for cirrhosis and viral hepatitis were observed.Results The level of ChE in observation group A and observation group B was lower than that in control group,and the levels of TBA and TBIL were higher than those in control group(P<0.05).The level of ChE in observation group A was lower than those in observation group B,and the levels of TBA and TBIL were higher than those in observation group B(P<0.05).The positive rates of serum ChE,TBA and TBIL in observation group A were higher than those in observation group B(P<0.05).The ChE of Child-pugh C patients in observation group A was lower than that of Child-pugh A and Child-pugh B patients,and TBA and TBIL were higher than those of Child-pugh A and Child-pugh B patients(P<0.05).The ChE of Child-pugh B patients was lower than that of Child-pugh A patients,and TBA and TBIL were higher than those of Child-pugh A patients(P<0.05).The sensitivity and specificity of combined detection of ChE+TBA+TBIL in the diagnosis of cirrhosis and viral hepatitis were higher than those of ChE,TBA and TBIL alone(P<0.05).Conclusion There are differences in serum ChE,TBA and TBIL levels between patients with viral hepatitis and cirrhosis,and the combined detection of ChE,TBA and TBIL can improve the diagnostic efficacy of cirrhosis and viral hepatitis,and can determine the degree of liver function damage in patients with cirrhosis to a certain extent,providing a reliable reference for clinical diagnosis and treatment.