肝脏硬度值和AST/ALT与原发性胆汁性胆管炎分期的相关性研究  

Correlation of liver stiffness measurements and AST/ALT with the stage of primary biliary cholangitis

作　　者：商宁[1] 黄秀香[2] 叶迎宾 张嫄[4] SHANG Ning;HUANG Xiu-xiang;YE Ying-bin;ZHANG Yuan(Department of Ultrasound Diagnostic,Handan Infectious Disease Hospital,(Handan Hebei,056002),China;不详)

机构地区：[1]河北省邯郸市传染病医院功能科,河北邯郸056002 [2]河北省邯郸市传染病医院肝病科 [3]河北省邯郸市传染病医院检验科 [4]首都医科大学附属北京佑安医院超声科

出　　处：《中西医结合肝病杂志》2023年第5期418-420,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：北京佑安医院2019年度院内中青年人才孵育项目(No.BJYAYY-GG2019-05);河北省医学科学研究课题计划(No.20220476)。

摘　　要：目的:分析肝脏硬度值(LSM)和肝功能不同指标与原发性胆汁性胆管炎(PBC)分期的相关性,为临床无创性检测和评估该病选择新指标。方法:选取北京佑安医院和邯郸市传染病医院就诊的原发性胆汁性胆管炎患者83例,均做肝穿刺病理活检,按结果进行病理分期分组:Ⅰ期18例为小胆管炎症期(炎症组);Ⅱ期20例为细小胆管增生期,Ⅲ期9例为瘢痕期(此两期为纤维化组);Ⅳ期36例为肝硬化期(肝硬化组)。对照组为正常体检者30例,男10例,女20例;3组患者和对照组人员均进行肝脏瞬时弹性技术检测,计算LSM值;同时检测3组患者和对照组人员肝功能指标,包括丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、AST/ALT、碱性磷酸酶(ALP)和谷氨酰氨基转移酶(γ-GGT),分析各指标与PBC分期的相关性。结果:①83例患者和正常体检人的性别比较,差异有统计学意义(均P<0.05)。83例患者的ALT、AST、ALP、γ-GGT、AST/ALT和LSM与对照组比较,差异有统计学意义(均P<0.05)。②肝硬化组患者的年龄均值最大,与其他两组比较,差异有统计学意义(均P<0.001)。③肝硬化组患者的AST/ALT、LSM值最高,与其他两组比较,差异有显著性意义(P<0.05);肝纤维化组患者的ALT、AST、ALP、γ-GT水平最高,与其他两组比较,差异有显著性意义(P<0.05)。④采用Spearman等级相关分析,结果表明AST/ALT与LSM与PBC分期呈正相关,AST/ALT和LSM越高可判断PBC为肝硬化期。结论:LSM值和AST/ALT可作为临床评估PBC分期的无创检测指标。Objective:To analyze the correlation between liver stiffness measurements(LSM)and different indexes of liver function and the staging of primary biliary cholangitis(PBC),select new indexes for clinical noninvasive detection and evaluation of the disease.Methods:A total of 83 patients with primary biliary cholangitis treated in Beijing You'an Hospital and Handan Infectious Disease Hospital were selected for liver puncture pathological biopsy.According to the results,18 patients in stageⅠwere grouped into the small bile duct inflammation stage(inflammation group).There were 20 cases of fine bile duct hyperplasia stageⅡand nine cases of cicatricial stageⅢ(liver fiber group).A total of 36 patients in stageⅣhad cirrhosis(cirrhosis group).A total of 30 normal physical examination subjects as control group,including 10 males and 20 females.The liver transient elasticity technique was used in the three groups and the control group and LSM value was calculated.At the same time,detected their liver function indexes,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),aspartate aminotransferase/alanine aminotransferase(AST/ALT),alkaline phosphatase(ALP)and glutamyl aminotransferase(γ-GGT),and analyzed the correlation between each index and PBC stage.Results:①The age of the control group was lower than that of the PBC group,and the difference was statistically significant(all P<0.01).The gender difference between the two groups was statistically significant(all P<0.05).There were significant differences in ALT,AST,ALP,γ-GGT,AST/ALT and LSM between PBC group and control group(all P<0.05).②The mean age of patients in the cirrhosis group was the largest,and the difference was statistically significant compared with the other two groups(P<0.001 for all).③The values of AST/ALT and LSM in cirrhosis group were the highest,and the difference was significant compared with the other two groups(P<0.05).The levels of ALT,AST,ALP,andγ-GGT in hepatic fibrosis group were the highest,and the difference wa

关 键 词：原发性胆汁性胆管炎 肝脏硬度值 天冬氨酸氨基转移酶 相关性 

分 类 号：R575.6[医药卫生—消化系统]