摘要
[目的]通过对乙型病毒性肝炎肝硬化(HBC)患者的生化指标ALB、GLB及A/G的表达情况进行分析,探讨其在HBC病情评估中的临床价值,为将来的临床诊治提供理论依据。[方法]选取2015年2月~2016年12月我院收治的非HBC慢性乙型病毒性肝炎及HBC患者作为研究对象,回顾分析符合条件的病例患者有无肝性脑病及腹水、胆红素、ALB、GLB、A/G、PT情况等资料,对HBC患者进行Child-Pugh评分与分级。[结果]HBC患者根据Child-Pugh评分进行分级:A级13例,B级14例,C级10例。肝硬化组随着Child-Pugh分级的提高,其血清ALB浓度、A/G值均逐步降低,而GLB浓度逐步升高,差异均有统计学意义(P<0.05)。HBC患者血清ALB浓度与Child-Pugh评分分级呈负相关(r=-0.932,P<0.01);GLB浓度与Child-Pugh评分分级呈正相关(r=0.949,P<0.01);A/G比值与Child-Pugh评分分级呈负相关(r=-0.945,P<0.01)。HBC评价参数中血清ALB的敏感度、特异度、约登指数分别为0.798、0.603、0.401;血清GLB的敏感度、特异度、约登指数分别为0.663、0.711、0.374;A/G比值的敏感度、特异度、约登指数分别为0.559、0.823、0.382。[结论]ALB、GLB、A/G比值对肝硬化代偿期的诊断具有重要的参考意义,可以对代偿期的肝硬化做出合理诊断,且具有很强的操作性和可行性。
[Objective]To investigate the expression and clinical significance of serum albumin and globulin in patients with viral hepatitis B cirrhosis and provide a theoretical basis for clinical diagnosis and treatment.[Methods]Patients with chronic hepatitis B and non liver cirrhosis and patients with HBC from February 2015 to December 2016 in our hospital were selected as the research object.The retrospective analysis was used to analyze data including hepatic encephalopathy and ascites,bilirubin,ALB,GLB,A/G,PT,Child-Pugh score and grade of HBC patients.[Results]There were Grade A 13 cases,Grade B 14 cases and Grade C 10 cases according to Child-Pugh score.With the improvement of Child-Pugh grade,the serum ALB concentration and A/G value of liver cirrhosis group were gradually reduced,while the GLB concentration gradually increased,the differences were statistically significant（P〈0.05）.The HBC levels of serum ALB and Child-Pugh score was negatively correlated（r=-0.932,P〈0.01）.GLB concentration and Child-Pugh score was positively correlated（r=0.949,P〈0.01）.The ratio of A/G and Child-Pugh score was negatively correlated（r=-0.945,P〈0.01）.The sensitivity,specificity and Jorden index of serum ALB in HBC evaluation were 0.798,0.603,0.401.The sensitivity,specificity and Jorden index of serum GLB were 0.663,0.711,0.374.The sensitivity,specificity and Jorden index of A/G were 0.559,0.823,0.382.[Conclusion]The ALB,GLB and A/G have an important reference value in the diagnosis of decom-pensated liver cirrhosis.It can be used to make a reasonable diagnosis of compensated cirrhosis,which has strong operability and feasibility.
出处
《中国中西医结合消化杂志》
CAS
2017年第8期625-628,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
关键词
乙型病毒性肝炎
肝硬化
白蛋白
球蛋白
临床意义
viralhepatitis B
liver cirrhosis
albumin
globulin
clinical significance
