早期甲胎蛋白测定对药物性肝损害患者转归的预测价值  

Value of early alpha fetoprotein detection in predicting prognosis of patients with drug-induced liver injury

作　　者：陈琰[1] 汤紫荣[2] 曹艳菊 屈昌民 梁淑文 房慧[1] 胡瑾华[2] 

机构地区：[1]解放军总医院消化内科,北京100853 [2]解放军第三0二医院肝衰竭中心 [3]解放军第三0六医院消化内科

出　　处：《中国医药》2015年第3期363-365,共3页China Medicine

摘　　要：目的探讨早期甲胎蛋白水平测定对药物性肝损害（DILI）转归的预测价值。方法纳入2011年7月至2014年7月解放军第三。二医院诊断为DILI的住院患者160例，根据入院后1周内初次甲胎蛋白检测值将其分为甲胎蛋白增高组（甲胎蛋白≥20μg／L）和甲胎蛋白正常组（甲胎蛋白〈20pog／L），每组80例。对2组患者进行生存预后分析。结果甲胎蛋白增高组和甲胎蛋白正常组年龄、性别、丙氨酸转氨酶、碱性磷酸酶比较差异无统计学意义（P〉0．05）；甲胎蛋白、总胆红素及住院时间比较，差异有统计学意义[82（45，153）ng／L比9（3，20）ng／L、（173±25）μmol／L比（70±15）μmol／L、（22．3±1．8）d比（11．6±1．2）d]（P〈0．01）。甲胎蛋白增高组与甲胎蛋白正常组重症病例发生率分别为22．5％（18／80）和1．3％（1／80），2组间差异有统计学意义（P〈0．01）。结论在DILI的早期监测中甲胎蛋白水平增高提示炎症严重，预后差，甲胎蛋白可作为预测DILI预后的指标之一。Objective To investigate the clinical significance of early alpha fetoprotein （AFP） detection in predicting prognosis of patients with drug-induced liver injury （DILI）. Methods Clinical data of 160 DILI patients who were admitted to 302th Hospital of Chinese People＇s Liberation Army from July 2011 to July 2014 were retrospectively analyzed. According to the levels of AFP within 1 week after admittion, the patients were divided into high AFP group （AFP≥20 μg/L, 80 cases） and normal group （AFP 〈20 μg/L, 80 cases）. The AFP and liver fimction were measured. Results There were no statistical differences in sex, average age, alanine aminotransferase（ALT） and alkaline phosphatase（ALP） between high AFP group and normal group （P 〉0.05 ）. However, high AFP group showed higher level of AFP, total bilirubin and total hospitalization days compared with those in normal group[ 82（45, 153） ng/L vs 9（3,20） ng/L, （ 173 ±25） μmol/L vs （70 ±15）μmol/L, （22.3 ±1.8 ） d vs （ 11.6 ±1.2） d ] （ P 〈 0.01 ）. In high AFP group the incidence of severe case was 22.5 % （ 18/80 ）, statistically higher than that in normal group [ 1.3 % （ 1/80 ） ] （ P 〈 0.01 ）. Conclusions High level of AFP in early stage indicates severe inflammation and poor prognosis, which may be used as an important marker for assessing the liver injury and predicting the prognosis in patients with DILI.

关 键 词：药物性肝损害 甲胎蛋白 预测价值 

分 类 号：R575.1[医药卫生—消化系统]