ADA、5’-NT、TRF、TBA、LAP和PA在肝病诊断中的临床评价  

Evaluation on diagnostic and prognostic values of ADA,5'-NT, TRF,TBA,LAP and PA in patients with liver diseases

作　　者：朱月蓉[1] 邱红[1] 王冰[1] 楼小伟[1] 何玉杰[1] 朱康正[1] 王志浩[1] 

机构地区：[1]解放军第八一医院生化科,江苏南京210002

出　　处：《安徽医药》2011年第6期728-730,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨腺苷脱氨酶(ADA)、5’-核苷酸酶(5’-NT)、转铁蛋白(TRF)、总胆汁酸(TBA)、亮氨酸氨基肽酶(LAP)、前白蛋白(PA)6项指标在肝病诊断和治疗中的价值。方法使用日立7600全自动生化分析仪测定41例急性肝炎、78例慢性肝炎、62例肝硬化、50例肝癌患者和53例健康对照者血清的上述6项指标,并对检测结果进行统计学分析。结果与正常对照组相比,急性肝炎组与肝癌组ADA、5’-NT、LAP显著升高(P<0.01),TRF和PA显著降低(P<0.01),TBA升高(P<0.05);慢性肝炎组中ADA、5’-NT、TBA、LAP与正常组相比有显著升高(P<0.01),而TRF、PA显著降低(P<0.01);肝硬化组中ADA、TBA与正常组相比有显著升高(P<0.01),而TRF、PA显著降低(P<0.01),5’-NT升高(P<0.05),但是肝硬化组的LAP与正常组无差异(P>0.05)。急性肝炎组受试者工作特性曲线(ROC)下面积5’-NT最大,慢性肝炎组曲线下面积ADA和PA较大,肝硬化组ADA、TBA和PA曲线下面积较大,肝癌组ADA、5’-NT和PA曲线下面积较大,LAP在慢性肝炎、肝硬化和肝癌组的曲线下面积较小。结论上述六项指标中,ADA和PA对肝病的诊断价值较高,可作为各实验室的常规项目开展,而除LAP外的其他5项指标对肝硬化均有较高临床应用价值。此外,上述6项指标与常规指标联合应用,可对临床医师在诊断、治疗、评估肝功能状况时起到重要的参考作用。Aim To discuss the diagnostic and prognostic values of adenosine deaminase（ADA）,5＇-Nucleotidase（5＇-NT）,transferrin（TRF）,total biliary acid（TBA）,leucine aminopeptidase（LAP）and prealbumin（PA）in patients with liver diseases.Methods The levels of ADA,5＇-NT,TRF,TBA,LAP and PA were determined by Hitachi 7600 auto analyzer and analyzed statistically in 41 patients with acute hepatitis,78 patients with chronic hepatitis,62 patients with cirrhosis,50 patients with liver cancer and 53 healthy controls.Results The levels of ADA,5＇-NT and LAP in patients with acute hepatitis or liver cancer were markedly higher than those in healthy controls（P0.01）and the levels of TRF and PA were markedly lower（P0.01）and the level of TBA was higher（P0.05）.The levels of ADA,5＇-NT,TBA and LAP in patients with chronic hepatitis were materially higher（P0.05）and the levels of TRF and PA were markedly lower（P0.01）.The levels of ADA and TBA in patients with cirrhosis were notably higher（P0.01）and the levels of TRF and PA were markedly lower（P0.01）and the level of 5＇-NT was higher（P0.05）,however,the level of LAP was similar to that of the normal subjects（P0.05）.The area under receiver operating characteristic curve（AUCROC）was the highest in 5＇-NT in acute hepatitis.AUCROC was higher in ADA and PA in chronic hepatitis.AUCROC was higher in ADA,TBA and PA in cirrhosis.AUCROC was higher in ADA,5＇-NT and PA in liver cancer.AUCROC was lower in LAP in chronic hepatitis,cirrhosis and liver cancer.Conclusion In above indexes,ADA and PA have higher values in liver disease diagnosis and can be used as routine item in library.Other five indexes besides LAP have higher clinical appliance values in hepatocirrhosis.Furthermore,the above six index can be associated with routine index.It is important for physicians to diagnose,treat,and evaluate liver status.

关 键 词：腺苷脱氨酶 5’-核苷酸酶 转铁蛋白 总胆汁酸 亮氨酸氨基前白蛋白 肝病 

分 类 号：R575[医药卫生—消化系统]