血清白蛋白/碱性磷酸酶比值对自身免疫性肝炎患者免疫抑制剂治疗效果的预测价值  

The value of the serum albumin to alkaline phosphatase ratio in predicting the efficacy of immunosuppressive therapy in patients with autoimmune hepatitis

作　　者：王婧婧[1] 张瑜[1] 韩振坤[1] WANG Jingjing;ZHANG Yu;HAN Zhenkun(Department of Clinical Laboratory,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan Province,China)

机构地区：[1]河南科技大学第一附属医院检验科,河南洛阳471003

出　　处：《新乡医学院学报》2025年第2期155-159,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨血清白蛋白/碱性磷酸酶比值(AAPR)对自身免疫性肝炎(AIH)患者免疫抑制剂治疗效果的预测价值。方法选择2016年1月至2022年12月河南科技大学第一附属医院收治的120例AIH患者作为AIH组,另选择同期在本院体检健康者30例作为健康对照组。治疗6个月后,评估AIH组患者的临床疗效,并根据临床疗效进一步将患者分为疗效不佳组(n=23)和疗效良好组(n=97)。健康对照组于体检当日、AIH组于就诊当日采集外周肘静脉血5 mL,3500 r·min^(-1)离心10 min,取血清,采用溴甲酚绿法检测血清白蛋白(ALB)水平,比色法检测血清碱性磷酸酶(ALP)水平,并计算AAPR。采用点二列相关性分析AAPR与AIH患者免疫抑制剂治疗效果的关系;采用受试者操作特征(ROC)曲线评估血清ALB、ALP及AAPR对AIH患者免疫抑制剂治疗效果的预测价值。结果AIH组患者血清ALB、AAPR水平显著低于健康对照组,ALP水平显著高于健康对照组(P<0.05)。疗效不佳组患者血清ALB、AAPR水平显著低于疗效良好组,ALP水平显著高于疗效良好组(P<0.05)。点二列相关性分析结果显示,AAPR与AIH患者免疫抑制剂治疗效果呈负相关(r=-0.325,P<0.05)。ROC曲线结果显示,治疗前血清ALB、ALP预测AIH患者免疫抑制剂治疗效果不佳风险的曲线下面积分别为0.673、0.646,预测价值较低;AAPR预测AIH患者免疫抑制剂治疗效果不佳风险的曲线下面积为0.735,有一定预测价值。结论AIH患者的AAPR较低,且其水平越低,患者免疫抑制剂治疗效果不佳的风险越高,其可作为AIH患者免疫抑制剂治疗效果的早期预测指标。Objective To investigate the value of the serum albumin to alkaline phosphatase ratio(AAPR)in predicting the efficacy of immunosuppressive therapy in patients with autoimmune hepatitis(AIH).Methods A total of 120 AIH patients admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2016 to December 2022 were selected as the AIH group,and another 30 healthy individuals who underwent physical examinations in the same hospital during the same period were selected as the healthy control group.After 6 months of treatment,the clinical efficacy of the AIH group was evaluated,and the patients were further divided into the poor efficacy group(n=23)and the good efficacy group(n=97)based on the clinical efficacy.About 5 mL of peripheral elbow vein blood was collected on the day of physical examinations for subjects in the healthy control group and on the day of admission for patients in the AIH group.Then,the sample was centrifuged at 3500 r·min^(-1) for 10 minutes,and serum was collected.The albumin(ALB)level was detected using the bromocresol green method,and the alkaline phosphatase(ALP)level was detected using the colorimetric method.Based on that,the AAPR was calculated.The point-biserial correlation analysis was used to investigate the relationship between the AAPR and the efficacy of immunosuppressive therapy in patients with AIH.The value of serum ALB,ALP,and AAPR in predicting the efficacy of immunosuppressive therapy in patients with AIH was evaluated by the receiver operating characteristic(ROC)curve.Results The serum ALB and AAPR levels of patients in the AIH group were significantly lower than those of the healthy control group,while the ALP level was significantly higher than that of the healthy control group(P<0.05).The serum ALB and AAPR levels of patients in the poor efficacy group were significantly lower than those in the good efficacy group,while the ALP level was significantly higher than that in the good efficacy group(P<0.05).The point-biserial correlation

关 键 词：自身免疫性肝炎 免疫抑制剂 白蛋白 碱性磷酸酶 

分 类 号：R575.1[医药卫生—消化系统]