血清中性粒细胞碱性磷酸酶在乙型肝炎病毒感染者中的变化及意义  

Changes and significance of serum neutrophil alkaline phosphatase in patients infected with hepatitis B virus

作　　者：陈开勇[1] 李海宁[2] 傅怀武 王敏[1] 张卫东 王绪山[1] Chen Kaiyong;Li Haining;Fu Huaiwu;Wang Min;Zhang Weidong;Wang Xushan(Department of Clinical Laboratory,Guanyun County People′s Hospital,Lianyungang,Jiangsu222200,China;College of Kangda,Nanjing Medical University,Lianyungang,Jiangsu222000,China;Department of Emergency,Guanyun County People′s Hospital,Lianyungang,Jiangsu 222200,China)

机构地区：[1]灌云县人民医院检验科,江苏连云港222200 [2]南京医科大学康达学院,江苏连云港222000 [3]灌云县人民医院急诊科,江苏连云港222200

出　　处：《实用医技杂志》2023年第6期390-393,共4页Journal of Practical Medical Techniques

基　　金：南京医科大学康达学院科研发展基金(KD2021KYYB21228)。

摘　　要：目的探讨血清中性粒细胞碱性磷酸酶在慢性乙型肝炎以及乙型肝炎后肝硬化患者中的表达及意义。方法选取慢性乙型肝炎相关疾病患者共102例,其中慢性乙型肝炎患者46例,乙型肝炎后肝硬化患者56例,肝硬化代偿期24例,肝硬化失代偿期32例,同时选取42名健康体检者作为对照,检测受试者血清中的中性粒细胞碱性磷酸酶(NAP)、丙氨酶转氨酶(ALT)、天冬氨酸转氨酶(AST)、白蛋白(ALB)、总胆红素(TBIL)、透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PⅢ)、Ⅳ型胶原(Ⅳ-C),比较血清NAP在组间的表达差异,分析其与其他实验室指标的相关性,以及评估血清NAP在肝硬化诊断中的价值。结果乙型肝炎后肝硬化组血清NAP[1502(633,1789)ng/ml]明显高于慢性乙型肝炎组[1101(811,1181)ng/ml]和对照组[138(110,152)ng/ml],慢性乙型肝炎组血清NAP明显高于对照组,乙型肝炎后肝硬化失代偿期的血清NAP浓度[1738(1300,1866)ng/ml]要高于乙型肝炎后肝硬化代偿期[1338(369,1506)ng/ml],差异具有统计学意义(P<0.05);血清NAP与ALT、AST、HA、LN、PⅢ、Ⅳ-C、天冬氨酸转氨酶和血小板比率指数(APRI)、肝纤维化4因子指数(FIB-4)呈正相关,与ALB、血小板呈负相关(P<0.05),血清NAP诊断肝硬化的ROC曲线下面积为0.738,最佳截断值为1263.64 ng/ml,敏感度和特异度分别为67.3%和100%。结论慢性乙型肝炎感染患者血清NAP水平升高,且其升高与疾病进展相关,血清NAP对乙型肝炎,慢性肝硬化的诊断具有一定应用价值。Objective To investigate the expression and significance of serum neutrophil alkaline phosphatase(NAP)in patients with chronic hepatitis B and hepatitis B-related cirrhosis.Methods A total of 102 patients with chronic hepatitis B-related diseases were selected,including 46 patients with chronic hepatitis B and 56 patients with liver cirrhosis after hepatitis B(24 cases with cirrhosis in the compensatory stage of liver cirrhosis and 32 cases with cirrhosis in the decompensated stage),and 42 healthy subjects were selected as controls.Serum NAP,alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),total bilirubin(TBIL),hyaluronic acid(HA),laminin(LN),typeⅢprocollagen(PⅢ),and typeⅣcollagen(Ⅳ-C)were detected.The expression differences of serum NAP between groups were compared,and the correlations with other laboratory indicators were analyzed,as well as the value of serum NAP in the diagnosis of liver cirrhosis.Results Serum NAP in the liver cirrhosis group after hepatitis B[1502(633,1789)ng/ml]was significantly higher than that in the chronic hepatitis B group[1101(811,1181)ng/ml]and the control group[138(110,152)ng/ml],and serum NAP in the chronic hepatitis B group was significantly higher than that in the control group.The serum NAP concentration in the decompensated stage of liver cirrhosis after hepatitis B[1738(1300,1866)ng/ml]was higher than that in the compensatory stage[1338(369,1506)ng/ml],with statistically significant differences(P<0.05).Serum NAP was positively correlated with ALT,AST,HA,LN,PⅢ,Ⅳ-C,APRI,and FIB-4,and negatively correlated with ALB and PLT(P<0.05),and there was no correlation between serum NAP and neutrophil count and percentage.The area under the ROC curve for serum NAP in the diagnosis of liver cirrhosis was 0.738,with the optimal cut-off value of 1263.64 ng/ml,and the sensitivity and specificity were 67.3%and 100%,respectively.Conclusion The serum NAP level was elevated in patients with chronic hepatitis B infection,which was related to the progression of

关 键 词：碱性磷酸酶 乙型肝炎 慢性 肝硬化 

分 类 号：R512.62[医药卫生—内科学]