Logistic回归分析评价血清蛋白电泳诊断乙型肝炎相关肝硬化  

Appraisement of Serum Protein Electrophoreses for Diagnos of Hepatitis B Associiated Cirrhosis by Binary Logistic Regression Analysis

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

机构地区：[1]上海市公共卫生临床中心肝炎二科,201508 [2]上海市公共卫生临床中心检验科,201508 [3]上海市公共卫生临床中心病理科,上海201508

出　　处：《临床消化病杂志》2011年第3期137-139,共3页Chinese Journal of Clinical Gastroenterology

基　　金：上海市科委科技计划项目(09411965800)

摘　　要：目的探讨血清蛋白电泳各组分含量构成比诊断乙型肝炎相关肝硬化的价值。方法慢性乙型肝炎189例,其中病理学诊断为肝硬化和非肝硬化的患者分别为47例和142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。结果肝硬化血清白蛋白、α2-球蛋白、β-球蛋白含量构成比显著低于非肝硬化者(P<0.05);血清α1-球蛋白、γ-球蛋白含量构成比显著高于非肝硬化者(P<0.05)。血清蛋白电泳各组分中,只有γ-球蛋白含量构成比符合Logistic回归分析自变量纳入标准(P<0.05)。基于血清蛋白电泳的γ-球蛋白含量构成比构建的Logistic回归模型诊断乙型肝炎相关肝硬化的灵敏度和特异度、阳性和阴性预测值、Youden指数和预测指数分别为0.759和0.844、0.468和0.951、0.603和0.419,准确度为0.831。结论血清蛋白电泳的血清γ-球蛋白含量构成比是诊断乙型肝炎相关肝硬化的一项比较可靠的指标。Objective To explore the efficacy of proporttons of fractions of serum protein electrophoreses for diagnosis of hepatitis B associated cirrhosis. Methods 189 consecutive patients with chronic hepatitis B were studied in which 47 patients and 142 patients were pathologically diagnosed as cirrhosis and non-cirrhosis respectively. The proportions of fractions of serum protein electrophoreses were measured by fully-automated hydrasys and auxiliary reagents（ Sebia Electrophoresis ,France）. Resuits The proportions of serum albumin, α2-glohulin, β-globulin in patients with cirrhosis were significantly lower than those in patients with non-cirrhosis （P 〈 0.05 ） ;the proportions of serum α1-globulin, γ-globulin in patients with cirrhosis were significantly higher than those in patients with non-cirrhosis （ P 〈 0.05 ）. Of the fractions of serum protein electrophoreses, only serum γ- globulin accorded with the entry criteria for Logistic regression analysis （ P 〈 0.05 ）. The sensitivity, specificity, positive predictive value,negative predictive value,Youden index, predictive index, accuracy of the Logistic regression model based on the proportions of serum γ- globulin for diagnosis of cirrhosis were 0. 759,0. 844,0. 468,0.951,0. 603,0. 419,0.831. Conclusion The proportions of serum γ-globulin based on serum protein electrophoreses is a reliable index for diagnosis of hepatitis B associated cirrhosis.

关 键 词：乙型肝炎 肝硬化 血清蛋白电泳 LOGISTIC回归分析 无创诊断 

分 类 号：R575.2[医药卫生—消化系统]