联合检测 PA，TBA 与肝穿刺活检在慢性肝炎中的临床价值  

Clinical Value of Combined Detection of Prealbumin Total Bile Acid and Liver Biopsy in Chronic Hepatitis

作　　者：白利芬[1] 李慧[1] 王兴宁[1] 

机构地区：[1]延安大学医学院附属医院检验科,陕西延安716000

出　　处：《现代检验医学杂志》2015年第4期50-52,共3页Journal of Modern Laboratory Medicine

摘　　要：目的：探讨联合检测前清蛋白（prealbumin，PA）、总胆汁酸（total bile acid，TBA）与肝穿刺活检，在慢性肝炎中的临床价值。方法收集延安大学附属医院2013年10月～2014年3月期间的慢性肝炎住院患者172例为慢性肝炎组，同期正常健康体检者45例为对照组。两组分别行 PA 和 TBA 检测，PA 采用免疫比浊法，TBA 采用循环酶法，慢性肝炎组同时行经皮穿刺肝组织学检测。结果慢性肝炎组 PA 值（179.12±8.46 mg／L）低于对照组（257.34±6.38 mg／L），差异具有统计学意义（P ＜0.05）；慢性肝炎组 TBA 值（30.58±9.37μmol／L）高于对照组（8.16±1.59μmol／L），差异具有统计学意义（P ＜0.05）；PA 含量与病理分级呈负相关（rs ＝－0.617，P ＜0.05），TBA 含量与病理分级呈正相关（rs ＝0.724，P ＜0.05）；PA 单独检测诊断阳性率为58.7％（101／172），TBA 单独检测诊断阳性率为80.2％（138／172）。两者联合检测诊断阳性率为93.6％（161／172），高于单独测定，差异具有统计学意义（P ＜0.05）。结论血清 PA 和 TBA 水平测定除能反映肝功能减退及肝内炎症程度以外，二者联合检测更能提高慢性肝炎诊断的阳性率，与组织学检测相比具有方便、简单、易操作的优点。Objective To investigate the clinical value of combined test of prealbumin （PA）,total bile acid（TBA）and liver bi-opsy in chronic hepatitis.Methods 172 patients hospitalized with chronic hepatitis in the Affiliated Hospital of Yan’an Uni-versity Medical College from October,2013 to March,2014 was collected as the chronic hepatitis group;and 45 cases of nor-mal healthy control of the corresponding period was collected as the control group.Prealbumin,TBA was detected respec-tively in the two groups.Immunoturbidimetry was adopted in PA,Enzymatic cycling assay was employed in TBA,and at the same time percutaneous puncture of liver histology was detected in the chronic hepatitis group.Results The PA in the chro-nic hepatitis group （179.12±8.46 mg/L）was lower than the control group （257.34±6.38 mg/L）,and the difference was statistically significant （P 〈0.05）.The TBA in the chronic hepatitis group （30.58±9.37 μmol/L）was higher than the con-trol group （8.16±1.59 μmol/L）and also the difference was statistically significant （P 〈0.05）.PA was negatively correla-ted with the pathological grades （rs =-0.617,P 〈0.05）,and TBA was positively correlated with pathological grades （rs =0.724,P 〈0.05）.The separate diagnostic positive rate of PA was 58.7% （101/172）,while the TBA was 93.6% （161/172）.The combined diagnostic positive rate of the two was 93.6% （161/172）,it was higher than the separate rate and was statistically significant （P 〈0.05）.Conclusion The serum levels of PA and TBA can reflect the extent and degree of hypo-hepatia and hepatic inflammation,and the combined detection of the two will be much sensitive to the diagnosis of chronic hepatitis,and compared with histological detection,it is convenient,simple,and easy to operate.

关 键 词：慢性肝炎 前清蛋白 总胆汁酸 肝穿刺活检 

分 类 号：R512.6[医药卫生—内科学] R446.1[医药卫生—临床医学]