血清蛋白电泳组分含量及其构成比在肝纤维化诊断中的应用  

Application of concentration and proportion of fractions of serum protein electrophoreses in diagnosing hepatitis B associated fibrotic levels

作　　者：张占卿[1] 陆伟[1] 王雁冰[1] 饶敏[1] 丁蓉蓉[1] 周毅[2] 冯艳玲[3] 

机构地区：[1]上海市（复旦大学附属）公共卫生临床中心肝炎二科,上海201508 [2]上海市（复旦大学附属）公共卫生临床中心检验科,上海201508 [3]上海市（复旦大学附属）公共卫生临床中心病理科,上海201508

出　　处：《世界感染杂志》2011年第2期93-98,共6页World Journal of Infection

基　　金：基金项目：上海市科委科技计划项目（09411965800）

摘　　要：目的探讨血清蛋白电泳诊断乙型肝炎相关肝纤维化程度的价值。方法慢性乙型肝炎189例，其中病理诊断为S0、S1、S2、S3、S4的患者分别为14例、43例、56例、29例、47例。血清蛋白电泳各组分含量构成比采用法国Sebia公司生产的Hydrasys全自动电泳仪及其配套试剂检测，血清总蛋白采用Roche全自动生化分析仪检测；血清蛋白电泳各组分含量-血清总蛋白xSPE各组分含量构成比。统计分析采用SPSS13．0软件。结果血清白蛋白、a2-球蛋白、β-球蛋白含量及其构成比与肝组织病理学分期呈显著负相关（P〈0．05），a1-球蛋白、γ-球蛋白含量及其构成比与肝组织病理学分期呈显著正相关（P〈0．05）。血清蛋白电泳各组分含量诊断显著肝纤维化（≥s2）、严重肝纤维化（≥S3）和肝硬化（=s4）的ROC曲线下面积相似于血清蛋白电泳各组分含量构成比诊断肝纤维化程度的ROC曲线下面积（P〉O．05）。血清白蛋白和γ-球蛋白含量构成比作为诊断肝纤维化程度的指标比较稳定，并且其诊断严重肝纤维化或肝硬化的价值能够达到中度水平（ROC曲线下面积0．7～0．9或0．1～0-3），其诊断严重肝纤维化和肝硬化的ROC曲线下面积分别为0．303和0．725、0．212和0．838。结论血清蛋白电泳各组分含量诊断乙型肝炎相关肝纤维化程度的效能并不优于SPE各组分含量构成比，血清白蛋白和γ-球蛋白含量构成比是比较可靠的诊断乙型肝炎相关严重肝纤维化和肝硬化的无创指标。Objective To explore the efficacy of serum protein electrophoreses for diagnosing hepatitis B associated fibrotic levels. Methods 189 patients with chronic hepatitis B were enrolled in present study, in which 14 patients, 43 patients, 56 patients, 29 patients, 47 patients were pathologically diagnosed as S0, S1, S2, S3, S4 respectively. The proportions of fractions of serum protein electrophoreses were measured by fully-automated Hydrasys and auxiliary reagents. Serum total protein was determined by fully-automated Roche multi analyzer and auxiliary reagents. The concentrations of fractions of serum protein electrophoreses .Serum total protein × The proportions of fractions of serum protein electrophoreses. SPSS 13.0 software was used for statistical analyses. Results The concentrations and proportions of serum albumin, a2-globulin, β-globulin were significantly negatively correlated with pathological staging of liver tissue （P 〈 0.05）; and those of serum a1-globuulin, γ-globulin were significantly positively correlated with pathological staging of liver tissue （P 〈 0.05）. The areas under ROC curve Of the concentrations of fractions of serum protein electrophoreses for diagnosis of significant fibrosis （≥S2）, Severe fibrosis （≥ S3） and cirrhosis （=S4） were similar to those of the proportions of fractions of serum protein electrophoreses for diagnosis of significant fibrosis, Severe fibrosis and cirrhosis （P 〉 0.05）. The proportions of serum albumin and γ-globulin for diagnosis of different fibrotic levels were more stable than those of other fractions of serum protein eleetrophoreses, and the efficacy of the proportions of serum albumin and γ-globulin for diagnosis of severe fibrosis, cirrhosis could reach moderate level （The area under ROC curve was between 0.7 and 0.9 or between 0.1 and 0.3）, and the areas under ROC curve for diagnosis of severe fibrosis, cirrhosis were 0.303 and 0.725, 0.212 and 0.838. Conclusions The efficacy of the concentrations of fractions of ser

关 键 词：血清蛋白电泳 乙型肝炎 肝纤维化 ROC曲线 无创诊断 

分 类 号：R575.2[医药卫生—消化系统]