血清HA、LN、hPCⅢ、CⅣ联合检测与病理诊断肝硬变及肝纤维化的对照研究  

DIAGNOSTIC VALUE OF SERUM HA, LN, hPCⅢ AND CⅣ DETECTION IN LIVER CIRRHOSIS OR FIBROSIS

作　　者：顾生旺[1] 章廉[2] 侯金林[2] 冯筱榕[2] 骆抗先[2] 翁介月[2] 

机构地区：[1]解放军第82医院传染结核科,江苏省淮阴市223001 [2]广州市南方医院

出　　处：《实用肝脏病杂志》1999年第3期134-136,共3页Journal of Practical Hepatology

摘　　要：目的 探讨血清纤维化标志诊断肝纤维化及肝硬变的价值。方法 用病理诊断作为金标准,参照各组各项纤维化标志分布的散点图,分别拟定肝硬变及肝纤维化的诊断截断点。按临床流行病学方法计算灵敏度、特异度等。结果 活动性肝硬变及早期肝硬变组四项纤维化标志升高最为明显:以HA≥190μg/L几为截断点诊断肝硬变的灵敏度为82.5％,特异度94.6％,准确度90.3％,拟定hPCⅢ≥160μg/L或HA≥70μg/L为截断点诊断肝纤维化,灵敏度分别为73.0％,70.6％;特异度83.3％,86.7％;准确度分别为74.0％,72.3％。LN和CⅣ诊断肝硬变和肝纤维化灵敏度均低于66.4％。结论 联合应用HA和hPCⅢ诊断肝硬变、肝纤维化有较高的临床价值。Objective To investigate the clinical value of serum fibrosis markers (SFM) for diagnosing liver cirrhosis (LC) and liver fibrosis (LF). Methods According to pathologic diagnosis, we selected different diagnostic cut off value and calculated the sensitivitysspecificity and accuracy. Results The four SFM significantly increased in the LC and LF. The sensitivity、specificity and accuracy were 82. 5% ,94. 6% ,90. 3% (HA≥190μg/L as cutoff value for LC).The sensitivity and specificity were 73.0%, 83. 3% (hPCⅢ≥160μg/L as cutoff for LF) and 70. 6% ,86.70% (HA≥170μg/L as cutoff for LF), respectively. The sensitivity was less than 66.4% (LN or CⅣ as di-agnosic marker for LF and LC). Conclusions Co-detection of HA and hPCⅢ in diagnosing LC and LF can improve the se、sp and accuracy.

关 键 词：透明质酸 层粘连蛋白 Ⅲ型胶原 肝纤维化 早期肝硬变 

分 类 号：R575.2[医药卫生—消化系统]