肝硬化失代偿期患者血清CA-125水平的影响因素及临床意义  

Clinical significance and influence factors of the level of serum CA-125 in patients with liver cirrhosis in decompensated stage

作　　者：易航 吕琳[1] 杨朝霞[1] 何松[1] YI Hang;LYU Lin;YANG Zhaoxia;HE Song(Department of Gastroenterology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院消化内科,重庆400010

出　　处：《现代医药卫生》2018年第7期987-990,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨血清CA-125水平在肝硬化失代偿期患者中的相关影响因素及临床意义。方法选取2017年1—6月在该科住院治疗的肝硬化失代偿期患者共292例。通过对患者血清CA-125水平、肝功能Child-Pugh分级、肝硬化病因、腹腔积液、自发性腹膜炎情况等相关指标进行汇总,进行影响血清CA-125水平的多元线性回归相关分析及受试者工作特征曲线(ROC曲线)分析,评估血清CA-125的影响因素及预测价值。结果自发性腹膜炎[非标准化系数(B)=89.966,95%可信区间(95%CI)26.21~145.72,P=0.005]和腹腔积液程度(B=161.850,95%CI 121.351~202.350,P=0.001)对肝硬化患者血清CA-125水平的影响具有统计学意义,而与肝硬化病因、转氨酶水平、合并肝癌及肝性脑病、肝功能Child-Pugh分级不具有统计学意义。血清CA-125达到180.50 U/m L预测自发性腹膜炎的敏感度为70.5%,特异度为75.4%;而当血清CA-125达到135.00 U/m L时,预测腹腔中-大量积液的敏感度可达88.3%,特异度为84.2%。结论肝硬化失代偿期患者血清CA-125水平存在变化,自发性腹膜炎和腹腔积液是影响其升高的主要因素。当血清CA-125水平分别高于180.50 U/m L及135.00 U/m L时可以较好地预测自发性腹膜炎及中-大量腹腔积液。Objective To investigate the relative influence factors and clinical significance of serum CA125 in pa tients with liver cirrhosis in decompensated stage.Methods A total of 292 patients with decompensated cirrhosis in our de partment from January 2017 to June 2017 were enrolled.Conditions of serum CA125 level,ChildPugh classification,etiology,severity of ascites,spontaneous bacterial peritonitis(SBP)were collected and statistics analysis such as multiple linear regres sion and ROC curve were performed to evaluate the influence factors and prediction values of serum CA125.Results SBP[nonstandardized coefficient(B)=89.966,95%CI 26.21 to 145.72,P=0.005]and severity of ascites(B=161.850,95%CI 121.351 to 202.350,P=0.001)were independent influence factors in CA125,but there was no significant correlation were found between CA125 and etiology,transaminase level,companion of hepatic carcinoma,hepatic encephalopathy and Child Pugh classification.When serum CA125 level reached 180.50 U/mL,the sensitivity and specificity of prediction of SBP will be 70.5%and 75.4%respectively;when CA125 reaches the level of 135.00 U/mL,sensitivity of predicting moderatesevere asci tes will be 88.3%,and specificity can be 84.2%.Conclusion Changes of serum CA125 can be found in patients with liver cir rhosis in decompensated stage.SBP and ascites are two main influence factors in CA125 elevation.Prediction of SBP and moderatesevere ascites can be precisely forecasted when serum CA125 is higher than 180.50 U/mL and 135.00 U/mL.

关 键 词：肝硬化 血清 自发性腹膜炎 腹腔积液 CA.125 Child.Pugh分级 预测 

分 类 号：R575.2[医药卫生—消化系统]