化学发光法检测肝纤维化血清学指标的临床应用  

Clinical application of serum markers for hepatic fibrosis detection by chemiluminescence

作　　者：姚真荣[1] 高玲[1] 颜绵生[1] 喻雄文[1] 邹燕群[1] 

机构地区：[1]中山大学附属第一医院检验医学部,广东广州510080

出　　处：《热带医学杂志》2011年第11期1264-1266,共3页Journal of Tropical Medicine

摘　　要：目的探讨化学发光法检测肝纤维化指标包括三型前胶原N端肽(PⅢNP)、Ⅳ型胶原(CⅣ)、层粘蛋白(LN)及透明质酸(HA)对肝纤维化的诊断价值。方法用化学发光法检测132例乙型病毒性肝炎患者血清中肝纤维化四项指标的水平,评价四项指标鉴别诊断肝炎及肝硬化的价值。结果乙型肝炎组、肝癌组、肝硬化组血清中的四项指标依次升高,均与正常对照组差异有统计学意义(P<0.01)。ROC曲线显示,PⅢNP、CIV、LN、HA的曲线下面积分别为0.680、0.825、0.716、0.825,灵敏度分别为39.1%、87.0%、87.0%、82.6%,特异性分别为89.8%、69.3%、53.4%、86.4%,准确性分别为79.09%、72.73%、78.18%、85.45%。在联合检测中,HA+PⅢNP组合的灵敏度为83.0%,特异性为80.0%,准确性为80.1%。结论单个指标检测,HA是四项指标中鉴别诊断肝炎与肝硬化最有价值的一项,通过HA联合其他指标进行分析,其中HA+PⅢNP组合特异性、准确性最高。Objective To evaluate the diagnostic value of serum liver fibrosis markers including procollagen type Ⅲ,Nterminal endopeptidase（PⅢNP）,collagen type IV（CIV）,laminin（LN） and hyaluronic acid（HA）.Methods The levels of serum PⅢNP,CⅣ,LN and HA were measured by chemiluminescence method in 132 patients with chronic hepatitis B（CHB） and in 60 healthy subjects.The diagnostic accuracy of serum markers for liver cirrhosis was evaluated by receiver operating characteristic curve.Results The levels of four fibrosis markers were increased in the chronic hepatitis B,hepatoma and liver cirrhosis compared with the control group（P〈0.01）.In ROC analysis,the AUC values of PⅢNP,CIV,LN and HA were 0.680,0.825,0.716 and 0.825,respectively;sensitivities were 39.1%,87.0%,87.0% and 82.6%,respectively;specificities were 89.8%,69.3%,53.4% and 86.4%,respectively;accuracies were 79.09%,72.73%,78.18% and 85.45%,respectively.In the combination assays,the sensitivity of HA ＋ PⅢNP was 83.0%,specificity was 80.0%,and accuracy was 80.1%.Conclusion HA is the best serum marker for diagnosis of liver cirrhosis.In the combination assays,HA＋PⅢNP was the best for diagnosis of liver cirrhosis,and could be recommended for the clinical diagnosis of liver cirrhosis.

关 键 词：化学发光法 肝纤维化 血清学指标 临床诊断性能(ROC)曲线 

分 类 号：R446.61[医药卫生—诊断学]