HBV DNA联合ALT对HBeAg阴性慢性活动性乙型肝炎的诊断价值  

Diagnostic value of HBV DNA combined ALT in HBeAg negative chronic active hepatitis B

作　　者：汪涛 刘娟 王婵 朱武 

机构地区：[1]安康市中医医院检验科,陕西安康725000

出　　处：《中国中西医结合消化杂志》2016年第8期582-585,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：[目的]探讨HBV DNA联合ALT对HBeAg阴性慢性活动性乙型肝炎的诊断价值。[方法]选取2014年8月-2015年11月于我院诊治的HBeAg阴性慢性乙型肝炎患者320例,根据肝组织活检结果分为慢性活动性乙型肝炎（229例）与慢性非活动性乙型肝炎（91例）,采用ROC曲线分析天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、HBV DNA、HBV DNA联合ALT诊断HBeAg阴性慢性活动性乙型肝炎的价值。[结果]与非活动性乙肝组比较,活动性乙肝组患者AST、ALT、HBV DNA水平较高（P〈0.001）。ROC曲线图显示,AST、ALT、HBV DNA、HBV DNA联合ALT曲线下面积分别为0.798、0.846、0.852、0.953（P〈0.05）。以AST≥40IU/L为标准诊断HBeAg阴性慢性活动性乙型肝炎时,其敏感性为78.4%、特异性为64.5%;以男性ALT≥30IU/L、女性ALT≥19IU/L为标准时,敏感性为90.3%、特异性为54.4%;以HBV DNA≥1×105cps/ml为标准时,敏感性为52.3%、特异性为98.4%;以男性ALT≥30IU/L、女性ALT≥19IU/L联合HBV DNA≥1×105cps/ml为标准时,敏感性为90.2%、特异性为98.6%。[结论]HBV DNA联合ALT诊断HBeAg阴性慢性活动性乙型肝炎的价值高于单用AST、ALT、HBV DNA,可以男性ALT≥30IU/L、女性ALT≥19IU/L联合HBV DNA≥1×105cps/ml为标准诊断HBeAg阴性慢性活动性乙型肝炎。[Objective]To explore the diagnostic value of HBV DNA combined ALT in HBeAg negative chronic active hepatitis B.[Methods]320patients with HBeAg negative chronic active hepatitis B from August 2014 to November 2015 in our hospital were divided into chronic active hepatitis B（229patients）and chronic non-active hepatitis B（91patients）according to liver biopsy results.Diagnostic value of AST,ALT,HBV DNA and HBV DNA combined ALT in HBeAg negative chronic active hepatitis B were analyzed by ROC curve.[Results]Compared to non-active hepatitis B group,patients in active hepatitis B group had higher level of AST,ALT,HBV DNA（P〈0.001）.ROC showed that AUC of AST,ALT,HBV DNA,HBV DNA combined ALT were 0.798,0.846,0.852,0.953（P〈0.05）.When the diagnostic criteria of AST was 40IU/L,the sensitivity and specificity were 78.4%,64.5%;while the diagnostic criteria of ALT of men and women were 30IU/L and 19IU/L,the sensitivity and specificity were 90.3%,54.4%;as the diagnostic criteria of AST、ALT、HBV DNA and HBV DNA was 1×105 copy/mL,the sensitivity and specificity were 52.3%,98.4%;and if the diagnostic criteria of ALT of men and women were 30IU/L and 19IU/L combined HBV DNA was 1×105 copy/mL,the sensitivity and specificity were 90.2%,98.6%.[Conclusion]The diagnostic value of HBV DNA combined ALT in HBeAg negative chronic active hepatitis B is higherthan single AST,ALT,HBV DNA,then ALT of men and women were 30IU/L and 19IU/L combined HBV DNA was 1×105 copy/mL are suggested to be the cut-off values for HBeAg negative chronic active hepatitis B.

关 键 词：乙型肝炎病毒 脱氧核糖核酸 丙氨酸氨基转移酶 活动性 诊断价值 

分 类 号：R575.1[医药卫生—消化系统]