血清胆碱酯酶活性对诊断亚急性乙型重型肝炎的价值探讨  

Early predictive value of serum cholinesterase for subacute severe hepatitis

作　　者：张占卿[1] 董华娟[1] 郝峥[1] 欧亚非[1] 黄绍萍[1] 朱翠云[1] 陆基华[1] 

机构地区：[1]上海市传染病医院肝炎科,上海200083

出　　处：《实用肝脏病杂志》2004年第4期208-210,共3页Journal of Practical Hepatology

摘　　要：目的　探讨血清胆碱酯酶 (Che)活性对亚急性乙型重型肝炎的诊断价值。方法　常规检测亚急性乙型重型肝炎与急性肝炎患者血清Che活性 ,血清Che活性对亚急性乙型重型肝炎与急性乙型肝炎的鉴别价值分析采用ROC曲线法。结果　亚急性重型肝炎血清Che活性 ( 5 44 7.7± 2 75 9.2 )u/L ,急性肝炎血清Che活性为 110 73 .6± 2 911.7u/L ,两者相比有显著性差异 (t =1.984,P =0 .0 0 0 )。鉴别亚急性重型肝炎与急性肝炎的血清Che活性的ROC曲线下面积0 .915 ,显著大于标准参考线下面积 (P =0 .0 0 0 )。以血清Che活性≥ 75 48u/L诊断急性肝炎而排除亚急性重型肝炎的灵敏度、特异度和准确度分别为 0 .883、0 .88和 0 .882 ,阳性和阴性预测值分别为 0 .95 8和 0 .710 ,阳性和阴性似然比分别为7.3 5 8和 0 .13 3。ObjectiveTo explore the diagnostic value of serum cholinesterase (Che) for subacute severe hepatitis. MethodsSPSS software 10.0 was used for statistic analysis. T test was used for comparing serum Che activities between subacute severe hepatitis and acute hepatitis, and ROC curve method was used for analyzing the value of serum Che activities in discriminating subacute severe hepatitis from acute hepatitis. ResultsSerum Che activities in subacute severe hepatitis and acute hepatitis were 5447.7±2759.2 u/L and 11073.6±2911.7 u/L respectively.There was a notably difference in serum Che activities between subacute severe hepatitis and acute hepatitis. The area under the ROC curve of serum Che activities for discriminating subacute severe hepatitis from acute hepatitis was 0.915, which was significantly larger than the area under the standard conference line. Taking serum Che ≥7548u/L as cut-off for diagnosing acute hepatitis and excluding subacute severe hepatitis, the sensitivity, specificity and accuracy were 0.883, 0.88 and 0.882 respectively; the positive and negative predictive value were 0.958 and 0.710 respectively; and the positive and negative likelihood ratio were 7.358 and 0.133.ConclusionSerum Che determination for excluding subacute severe hepatitis from acute hepatitis is very reliable.

关 键 词：血清胆碱酯酶 亚急性重型肝炎 诊断 重型肝炎 急性肝炎 乙型 酶活性 活性测定 

分 类 号：R512.62[医药卫生—内科学]