白蛋白与碱性磷酸酶比值在乙型肝炎肝硬化预测中的临床价值

Value of albumin to alkaline phosphatase ratio in the clinical prediction of hepatitis B cirrhosis

目的研究白蛋白(ALB)与碱性磷酸酶(ALP)比值(AAPR)在乙型肝炎肝硬化预测中的临床价值。方法回顾性选取2019年8月至2020年12月黄山市人民医院入院的慢性乙肝病毒(HBV)感染患者100例,参考不同病症类型,将慢性乙肝患者作为乙肝组(n=54),将慢性乙肝肝硬化患者作为乙肝肝硬化组(n=46);同时,选取同一时期入院进行体检的50名健康者作为健康组。比较3组研究对象的ALB、ALP与AAPR水平;另外,参考HBV-DNA表达情况将乙肝肝硬化组46例患者分为阳性组(n=23)与阴性组(n=23),对比两组患者的ALB、ALP及AAPR水平。采用受试者操作特征(ROC)曲线分析AAPR在乙肝肝硬化预测中的临床价值。结果乙肝肝硬化组患者的ALB、AAPR分别为(33.61±8.53)g/L、0.36±0.14,均明显低于乙肝组[(43.98±4.87)g/L、0.54±0.14]与健康组[(47.25±2.62)g/L、0.69±0.17],乙肝肝硬化组患者的ALP为(116±57)U/L,明显高于乙肝组[(86±25)U/L]、健康组[(72±14)U/L],差异均有统计学意义(P<0.05);乙肝组患者的ALB、AAPR明显低于健康组,ALP水平明显高于健康组,差异均有统计学意义(P<0.05)。阳性患者的ALB、AAPR分别为(30.57±6.98)g/L、0.30±0.13,均低于阴性患者[(35.86±8.95)g/L、0.39±0.16],ALP水平为(135±71)U/L,高于阴性患者[(97±31)U/L],差异均有统计学意义(P<0.05)。ROC曲线分析显示,AAPR预测乙肝肝硬化的曲线下面积为0.802,高于ALB(0.721)、ALP(0.736)。结论AAPR在乙肝肝硬化预测中临床价值显著,可为早期阶段乙肝肝硬化诊断提供参考依据。

Objective To investigate the clinical value of albumin(ALB)to alkaline phosphatase(ALP)ratio(AAPR)in the prediction of hepatitis B cirrhosis.Methods A total of 100 patients with chronic hepatitis B virus(HBV)infection admitted to Huangshan People's Hospital from August 2019 to December 2020 were retrospectively selected.According to different types of diseases,patients with chronic hepatitis B were divided into the hepatitis B group(n=54)and patients with chronic hepatitis B cirrhosis were divided into the hepatitis B cirrhosis group(n=46).Meanwhile,50 healthy patients admitted during the same period for physical examination were selected as the healthy group.The ALB level,ALP level and AAPR of the three groups were compared.According to the expression of HBV-DNA,46 patients in the hepatitis B cirrhosis group were divided into the positive group(n=23)and the negative group(n=23),and ALB,ALP and AAPR of the two groups were compared.The clinical value of AAPR in the prediction of hepatitis B cirrhosis was analyzed using the receiver operating characteristic(ROC)curve.Results The ALB and AAPR in the hepatitis B cirrhosis group were(33.61±8.53)g/L and 0.36±0.14,respectively,which were significantly lower than those in the hepatitis B group[(43.98±4.87)g/L,0.54±0.14]and the healthy group[(47.25±2.62)g/L,0.69±0.17],the ALP in the hepatitis B cirrhosis group was(116±57)U/L,which was significantly higher than that in the hepatitis B group[(86±25)U/L]and the healthy group[(72±14)U/L],and the differences were statistically significant(P<0.05).The ALB and AAPR in the hepatitis B group were significantly lower than those in the healthy group,and the ALP level was significantly higher than that in the healthy group,the differences were statistically significant(P<0.05).The ALB and AAPR of positive patients were(30.57±6.98)g/L and 0.30±0.13,which were lower than those of negative patients[(35.86±8.95)g/L and 0.39±0.16],and the ALP level was(135±71)U/L,which was higher than that of negative patients[(97±31)U/L],the differences were statistically significant(P<0.05).ROC curve analysis showed that the area under the curve of AAPR in the predicted of hepatitis B cirrhosis was 0.802,higher than ALB(0.721)and ALP(0.736).Conclusion AAPR has significant clinical value in the prediction of hepatitis B cirrhosis and can provide a reference for the diagnosis of hepatitis B cirrhosis in the early stage.