CHE、ALB、CHO在肝炎肝硬化患者中的表达及诊断效能影响研究  

A Study on the Expression and Diagnostic Efficacy of CHE,ALB and CHO in Patients with Hepatitis Cirrhosis

作　　者：张映华[1] 古晓娟 ZHANG Yinghua;GU Xiaojuan(Department of Laboratory,Yibin Second People′s Hospital,Yibin 646000,China;Respiratory Department,Yibin Second People′s Hospital,Yibin 646000,China)

机构地区：[1]宜宾市第二人民医院检验科,四川宜宾646000 [2]宜宾市第二人民医院呼吸科,四川宜宾646000

出　　处：《标记免疫分析与临床》2020年第3期497-501,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的分析血清中胆碱酯酶活性(cholinesterase activity,CHE)、白蛋白(albumin,ALB)和胆固醇(cholesterol,CHO)在肝炎肝硬化患者中的表达及诊断效能的影响。方法选取我院2018年1月至2019年2月就诊的肝炎肝硬化患者118例为肝硬化组,乙型肝炎患者61例为肝炎组,同期选择115例行体检的健康者为对照组,肝硬化组和肝炎组按照Child-Pugh标准分为A、B、C级三组,比较各组和A、B、C级三组间肝功能CHE、ALB、CHO水平,对各指标临床诊断的效能进行分析。结果肝炎组和肝硬化患者血清CHE、CHO、ALB水平较对照组均显著降低,差异均具有统计学意义(P<0.05);肝硬化组CHE、CHO和ALB水平随ABC三级呈下降趋势,各级组间差异有统计学意义(P<0.05);A、B、C级三组间CHE、CHO、ALB阳性率差异均无统计学意义(P>0.05),各级组内CHE、CHO、ALB阳性率相比,CHE阳性率高于CHO和ALB,且差异有统计学意义(P<0.05);CHE和CHO、CHE和ALB、CHO和ALB相关系数分别为0.846、0.768和0.884(均P<0.05),临床效能显示CHE/CHO/ALB的灵敏度最高100%,CHE的特异性最高95.2%,CHE/CHO/ALB的AUC曲线下面积最高为0.947。结论CHE、CHO、ALB水平在肝炎肝硬化患者中显著降低,与Child-Pugh分级间具有一定相关性,CHE、CHO、ALB单项诊断时,CHE灵敏度最强,但联合检测肝炎肝硬化患者时,诊断效能最佳。Objective To analyze the effects on the expression and diagnostic efficacy of serum cholinesterase(CHE),albumin(ALB)and cholesterol(CHO)in patients with hepatitis cirrhosis.Methods A total of 118 patients with hepatitis cirrhosis who were treated in our hospital from January,2018 to February,2019 were enrolled as the cirrhosis group,while 61 patients with hepatitis B as the hepatitis group and another 115 healthy subjects underwent physical examination as the control group.The cirrhosis group and hepatitis group were further divided into A,B and C level groups according to Child-Pugh criteria.The liver function indexes,including CHE,ALB,and CHO levels,and clinical diagnostic efficacy were compared among those groups,and A,B,C level sub-groups.Results The levels of serum CHE,CHO and ALB in the cirrhosis group and hepatitis group were significantly lower than those in the control group(P<0.05).The levels of CHE,CHO and ALB decreased with ABC levels in the cirrhosis group(P<0.05).There was no significant difference in the positive rates of CHE,CHO and ALB among the groups of A,B and C(P>0.05).By comparing the positive rates of CHE,CHO and ALB in each group,the positive rate of CHE was higher than that of CHO and ALB(P<0.05).The correlation coefficients of CHE and CHO,CHE and ALB,CHO and ALB were 0.846,0.768 and 0.884,respectively(all P<0.05).The clinical efficacy showed that the sensitivity of CHE/CHO/ALB was the highest with 100%,the specificity of CHE was highest with 95.2%,and the area under the ROC curve(AUC)for CHE/CHO/ALB was 0.947.Conclusion The levels of CHE,CHO and ALB are significantly lower in patients with hepatitis cirrhosis and have a observable correlation with Child-Pugh classification,in which CHE has the highest sensitivity,while the combined detection has the best diagnostic performance in patients with hepatitis cirrhosis.

关 键 词：肝炎 肝硬化 肝功能 胆碱酯酶 白蛋白 胆固醇 诊断效能 

分 类 号：R575.2[医药卫生—消化系统]