血清γ-谷氨酰转移酶、碱性磷酸酶在胆总管小结石诊断中的临床价值  

Clinical value of serum γ-glutamyl transferase and alkaline phosphatase in the diagnosis of bile duct stones

作　　者：杨海军[1] 赵海滨[1] 杜峰华 高迎军[1] 刘兵[1] 刘健康 

机构地区：[1]固安县人民医院外科,河北廊坊065500 [2]固安县中医院外科

出　　处：《海军医学杂志》2017年第6期517-520,共4页Journal of Navy Medicine

基　　金：廊坊市科技支撑计划项目(2015013029)

摘　　要：目的研究并探讨血清γ-谷氨酰转移酶(gamma glutamyl transferase,GGT)和碱性磷酸酶(alkaline phosphatase,ALP)在胆总管小结石诊断中的临床应用价值。方法选取2013年1月至2016年12月河北省廊坊市固安县人民医院和固安县中医院接收的150例疑似合并胆总管小结石的胆囊结石患者,对其进行胆囊切除术,术中探查胆管以明确是否存在胆总管小结石。另选取50例健康体检正常者作为对照组,胆囊结石患者手术前、对照组体检者均接受血清GGT和ALP测定,统计GGT和ALP阳性检出结果,以手术诊断结果为金标准,分析GGT和ALP对胆总管小结石的诊断结果。将手术确诊胆总管小结石患者归为阳性组,其余归为阴性组,比较阳性组、阴性组和对照组的血清GGT和ALP表达水平。结果 150例胆囊结石患者中,共有98例患者经手术探查明确合并有胆总管小结石。GGT和ALP对胆总管小结石的诊断灵敏度、特异度、准确性比较差异无统计学意义(P>0.05),其诊断结果与手术诊断结果之间均具有良好的一致性(Kappa=0.735、0.719)。对照组、阴性组和阳性组患者的血清GGT和ALP表达水平比较,差异具有统计学意义(P<0.05)。结论在胆总管小结石的诊断中,测定血清γ-谷氨酰转移酶、碱性磷酸酶可有效检出胆总管结石,可作为胆总管小结石的辅助诊断指标。Objective To investigate the clinical value of serum γ-glutamyl transferase(GGT) and alkaline phosphatase(ALP) in the diagnosis of bile duct stones.Methods One hundred and fifty suspected patients with common bile duct stones complicated with gallstone admitted into the hospital for treatment from January 2013 to December 2016 were selected as research subjects.The patients underwent cholecystectomy,during which intraoperative bile duct exploration was performed to determine the presence of common bile duct stones.In addition,50 healthy subjects from normal examinees were selected as the control group.Both the patients with gallstones before surgery and the control group subjects were all detected for the levels of serum GGT and ALP.Statistical analysis was made to found out the positive results of GGT and ALP detection.By using surgical diagnostic results as the gold standards,GGT and ALP were applied to identify the diagnostic results of common bile duct stones.The patients diagnosed to be small common bile duct calculi by surgery were designated as the positive group and the remaining patients were assigned as the negative group.Then,the expression levels of serum GGT and ALP were compared between the 3 groups.Results In the 150 gallstone patients,there were a total of 98 patients who were diagnosed by surgical exploration to have small common bile duct calculi.There was no statistical significance in the diagnostic sensitivity,specificity and accuracy of bile duct stones,when comparisons were made between surgical diagnostic results and GGT and ALP results(P>0.05),and there was good agreement between these two diagnostic methods(Kappa=0.735,0.719).There was statistical significance in the expression levels of GGT and ALP,when comparisons were made between the control group,the negative group and the positive group(P<0.05).Conclusion In the diagnosis of bile duct stones,the detection of serum γ-glutamyl transferase and alkaline phosphatase could be used to effectively identify bile duct stones,and be applied

关 键 词：胆总管小结石 诊断 Γ-谷氨酰转移酶 碱性磷酸酶 

分 类 号：R34[医药卫生—基础医学]