肝硬化患者血清生物标志物水平的测定及早期诊断的临床分析  

The clinical analysis of early diagnosis and determination of serum biomarkers level in the patients with hepato-cirrhosis

作　　者：吴健媛[1] 陈如昌[1] 陈燕勤[1] 

机构地区：[1]义乌市中心医院检验科,浙江义乌322000

出　　处：《中国卫生检验杂志》2015年第15期2521-2524,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨肝硬化患者血清生物标志物水平的测定及早期诊断的临床分析。方法分析283例肝硬化患者和140例正常对照者血清透明质酸酶(HA)、肝胆酸(CG)、Ⅲ型前胶原氨端肽(PⅢNP)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胺原(CⅣ)和层黏连蛋白(LN)水平以及血清CA125、CA199、Hcy和Ins,并进行对比性分析。采用受试者工作特征曲线(ROC曲线)评价生物标志物CA125、CA199、Hcy和Ins,预测肝硬化早期诊断的临床价值。结果肝硬化患者血清HA、CG、PⅢNP、PCⅢ、CⅣ和LN水平较正常对照组明显增高,差异有统计学意义(P<0.001)。肝硬化患者生物标志物(CA125、CA199、Hcy和Ins)水平较正常对照组明显增高,差异有统计学意义(P<0.001)。从早期诊断而言,A级组肝硬化血清CA125和CA199水平较正常对照组增高,差异有统计学意义(P<0.05),而血清Hcy和Ins水平较正常对照组明显增高,差异有统计学意义(P<0.01)。ROC曲线分析显示,血清CA125、CA199、Hcy和Ins对肝硬化早期诊断的最佳临界值分别为25.47 IU/ml、26.49 IU/ml、12.43μmol/L和15.31 u IU/ml,敏感度分别为34.28%、33.67%、78.20%和81.57%,特异度分别为58.27%、55.16%、94.11%和95.23%,以血清Hcy和Ins水平为好。结论肝硬化是一个可逆性病理过程,应该进行肝硬化早期诊断的基础研究,从而延缓肝硬化的发生和发展。Objective To explore the clinical analysis of early diagnosis and determination of serum biomarkers level in the patients with hepato- corrihosis. Methods The serum HA,CG,PⅢNP,PCⅢ,CⅣ and LN levels and serum CA125,CA199,Hcy and Ins levels in 283 patients with hepato- corrihosisand 140 controls were compared and analyzed. And using the receiver operating characteristic curve（ ROC curve） evaluated the biomarkers（ CA125,CA199,Hcy and Ins） and predicted the chlinical value of early diagnosis. Results The serum HA,CG,PⅢNP,PCⅢ,CⅣ and LN levels in patients with hepato- corrihosis were significantly higher than those in controls and the difference had statistical significance（P〈0. 001）. The serum biomarkers（ CA125,CA199,Hcy and Ins） levels in patients with hepato- corrihosis significantly increased when compared with those in controls and the difference had statistical significance（P〈0. 001）. In the hepato- corrihosis early diagnosis,the serum CA125 and CA199 levels in A group with hepato- corrihosis increased when compared with the controls and the difference had statistical significance（P〈0. 05）,but the serum Hcy and Ins levels were significantly increased when compared with the controls when compared with the controls（P〈0. 01）. ROC curve analysis showed： the cut- off value of serum CA125,CA199,Hcy and Ins for hepato- corrihosis early diagnosis were 25. 47 IU / ml,26. 49 IU / ml,12. 43 μmol / L and 15. 31 u IU /ml,respectively,the sensitivity were 34. 28%,33. 67%,78. 20% and 81. 57%,respectively,the specificity were 58. 27%,55. 16%,94. 11% and 95. 23%,respectively. The level of serum Hcy and Ins was good. Conclusion The hepato- corrihosis was a reversible pathological process,basis study for early diagnosis should be done so as to avoid and delay the occurrence and development of hepato- corrihosis.

关 键 词：肝硬化 生化指标 生物标志物 受试者工作特征曲线 早期诊断 

分 类 号：R575.1[医药卫生—消化系统]