摘要
目的:探究肝硬化相关血清学指标与肝硬化Child-Pugh分级之间的关系和临床意义。方法:收集重庆医科大学附属第二医院感染科2016年7月至2017年4月间肝硬化患者血清235例,其中Child-Pugh A组55例,B组90例,C组90例,以及同期健康体检人群35例,分别检测肝功能、肝纤维化、血小板计数等指标并分析其特征。结果:透明质酸(hyaluronic acid,HA)、层粘连蛋白(laminin,LN)、Ⅲ型胶原蛋白(typeⅢcollagen,PC-Ⅲ)、Ⅳ型胶原蛋白(typeⅣcollagen,Ⅳ-C)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、丙氨酰氨基转移酶(alanyl aminotransferase,ALT)及天门冬氨酸氨基转移酶与血小板计数比(aspartate aminotransferase to platelet ratio index,APRI)指数之间差异均具有统计学意义(P<0.05)。HA、PC-Ⅲ、Ⅳ-C、LN和AST指标对预测肝硬化的曲线下面积(AUC)分别为0.910、0.804、0.833、0.753、0.730。HA、PC-Ⅲ、Ⅳ-C与Child-Pugh分级呈高度正相关(r>0.7,P<0.01),APRI与分级呈显著性正相关(0.4<r<0.7,P<0.05)。结论:HA、PC-Ⅲ、Ⅳ-C、APRI可作为Child-Pugh分级的潜在临床指标,这将有助于临床更好地制定诊疗方案及预后评估。
Objective:To investigate the correlation between serological markers for liver cirrhosis and Child-Pugh class and its clinical significance. Methods:A total of 235 patients with liver cirrhosis who were treated in Department of Infectious Diseases in The Second Affiliated Hospital of Chongqing Medical University from July 2016 to April 2017 were enrolled,among whom 55 had ChildPugh class A cirrhosis,90 had Child-Pugh class B cirrhosis,and 90 had Child-Pugh class C cirrhosis,and 35 individuals who underwent physical examination during the same period of time were enrolled as controls. The indices including liver function parameters,liver fibrosis indices,and platelet count were measured and analyzed. Results:There were significant differences between the two groups in hyaluronic acid(HA),laminin(LN),type Ⅲ collagen(PC-Ⅲ),type Ⅳ collagen(Ⅳ-C),aspartate aminotransferase(AST),alanine aminotransferase(ALT),and aspartate aminotransferase-to-platelet ratio index(APRI)(P<0.05). HA,PC-Ⅲ,Ⅳ-C,LN,and AST had an area under the ROC curve of 0.910,0.804,0.833,0.753,and 0.730,respectively. HA,PC-Ⅲ,and Ⅳ-C were positively correlated with Child-Pugh class(r>0.7,P<0.01),and APRI was positively correlated with Child-Pugh score(0.4<r<0.7,P<0.05).Conclusion:HA,PC-Ⅲ,Ⅳ-C,and APRI can be used as potential clinical indices for Child-Pugh class,which will help to better develop diagnosis and treatment regimens and perform prognostic evaluation.
作者
李丹丹
杜燕娥
段亮
李朴
麦力
王玎
Li Dan dan;Du Y one;Duan Liang;Li Pu;Mai Li;Wang Ding(Medical Laboratory,the Second Affiliated Hospital,Chongqing Medical University)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2019年第3期336-339,共4页
Journal of Chongqing Medical University
基金
重庆市教委资助项目(编号:KJ1600220)
