血清学指标甲胎蛋白总胆红素丙氨酸转氨酶和凝血酶原活动度与肝纤维化进程的相关性分析  

The Correlation analysis of serological indexes alpha fetal protein, total bilirubin, al anine aminotransferase and prothrombin time activity with the process of liver fibrosis

作　　者：何娴[1] 丘元福 庄健海[1] 陈家钖[1] 吕丽珍[1] 钟幸容 

机构地区：[1]广东省佛山市中医院检验医学中心,528000

出　　处：《实用医技杂志》2018年第2期125-127,共3页Journal of Practical Medical Techniques

基　　金：广东省佛山市卫生和计划生育局医学科研课题(2017-0085)

摘　　要：目的分析血清学指标甲胎蛋白(AFP)、总胆红素(TBiL)、丙氨酸转氨酶(ALT)和凝血酶原活动度(PTA)在慢性乙型肝炎患者肝纤维化进程中的变化,探讨其与肝组织炎症分级(G)和纤维化分期(S)的关系。方法回顾性分析我院162例慢性乙型肝炎住院患者的肝活体穿刺病理结果和同期进行检测的血清学指标AFP、TBiL、ALT和PTA,并选取同期50名体检者作为对照组。结果(1)与对照组比较,慢性乙型肝炎住院患者血清AFP、ALT和TBiL水平显著升高,而PTA水平降低显著,差异有统计学意义(P<0.01)。(2)慢性乙型肝炎住院患者在炎症分级组中,TBiL指标水平的组间差异无统计学意义;除了G2组AFP较G1组稍有降低,其余组的AFP和ALT均随着炎症分级的升高而升高;PTA水平与炎症分级呈负相关。(3)在纤维化分期中,AFP和TBiL的水平变化与分期呈正相关,且这个指标水平的组间差异有统计学意义(P<0.01);PTA水平除S2组稍高于S1组外,其他组的PTA水平随分期增加而降低;而各分期间的ALT水平差异无统计学意义(P>0.01)。结论AFP、TBiL、ALT和PTA联合检测对临床判断慢性乙型肝炎患者的肝纤维化进程有重要意义,可以反映肝组织的炎症程度和病变进展,有助于对早期肝硬化的预测。Objective To analyze the changes of alt and total bilirubin(TBiL)in liver fibrosis in patients withchronic hepatitis B(CHB).To explore the relationship between liver inflammation grade(G)and fibrosis stage(S).Methods The pathological results of liver biopsy in162patients with chronic hepatitis B were retrospectively analyzed,and the serological indexes alpha fetal protein(AFP)鄄TBiL T alt and prothrombin time activitys(PTAs)were measured inthe same period.50cases of normal physical examination were selected as control group.Results The levels of alt andTBiL in patients with chronic hepatitis B were significantly higher than those in patients with chronic hepatitis B.The levelof PTA decreased significantly(P<0.01).There was no significant difference between the two groups in the inflammatorygrading group,except that in G2group,the level of AFP was slightly lower than that in G1group,and there was nosignificant difference between the two groups,except that in G2group,the level of AFP was slightly lower than that in G1group.In other groups,the levels of AFP and ALT increased with the increase of inflammatory grade.There was a negativecorrelation between the levels of ALT and inflammatory grade and the changes of TBiL and TBiL levels in fibrosis stagewere positively correlated with the stage.The difference of this index level was statistically significant(P<0.01).The PTAlevel in S2group was higher than that in S1group,except that in S2group,it was higher than that in S1group.The levelof PTA decreased with the increase of stage,but there was no significant difference in the level of ALT between the twogroups(P>0.01).Conclusion The combined detection of alt and PTA in patients with chronic hepatitis B is of greatsignificance in clinical diagnosis of hepatic fibrosis process in patients with chronic

关 键 词：肝炎 乙型 慢性 血清学指标 纤维化分期 炎症分级 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]