摘要
目的探讨彩色超声与血清D-二聚体(D-dimer,D-D)、白蛋白(Albumin,ALB)和总胆红素(TBil)水平评价肝硬化严重程度和向原发性肝癌转化时的临床价值。方法189例肝硬化(LC)患者(A级组67例、B级组56例和C级组66例)和76例原发性肝癌(PLC)患者进行了彩色多普勒超声诊断仪检查,并与120例正常对照组测定了血清D-D、ALB和TBil水平,并进行了对比性研究。受试者工作特征曲线(ROC)评价晚期LC向PLC患者转化时的临床价值。结果在彩色超声上,肝纤维化(liver fibrosis,LF)、LC和PLC之间具有明显差异。189例LC患者和76例PLC患者血清D-D水平较之120例正常对照组显著增高(P<0.001),血清ALB和TBil水平均降低(P均<0.05)差异有统计学意义。血清D-D、ALB和TBil的曲线下面积(AUC)分别为0.924、0.751和0.748,临界值分别为1.28 mg/L、23.69 g/L和8.39μmol/ml,敏感度分别为92.38%、70.57%和69.32%,特异度分别为96.12%、80.46%和79.35%。结论B超与血清D-D、ALB和TBil水平具有早期诊断和鉴别诊断LF、LC和PLC的临床价值。血清D-D、ALB和TBil水平是晚期LC向PLC转化时的有价值指标,以D-D为最佳。
Objective To explore the clinical value of B ultrasonography,serum D-D,ALB and TBil levels in predicting liver cirrhosis( LC) severity and translating primary liver cancer( PLC).Methods A total of 189 patients with LC( 67 cases in A Class,56 cases in B Class and 66 cases in C Class) and 76 patients with PLC underwent color Dopplar ultrasonography.The serum D-D,ALB and TBil levels were detected and compared with that in 120 controls for analysis.The receiver operating characteristic curve( ROC curve) is used to evaluate the clinical value of late LC conversion to PLC patients.Results There were significant differences in color ultrasound between liver fibrosis( LF),LC,and PLC.The serum D-D level of 189 LC patients and 76 PLC patients was significantly higher than that of 120 normal controls( P<0.001),and the serum ALB and TBil levels were decreased( P<0.05).The Area under curre( AUC) of serum D-D,ALB and TBil were 0.924,0.751 and0.748,respectively.The critical values were 1.28 mg/L,23.69 g/L and 8.39 umol/ml.The sensitivities were 92.38%,70.57% and 69.32%,and the specificity was 96.12%,80.46% and 79.35%,respectively.Conclusion B-ultrasound and serum D-D,ALB and TBil levels have the clinical value of early diagnosis and differential diagnosis of LF,LC and PLC.Serum levels of D-D,ALB and TBil are valuable indicators for the conversion of late LC to PLC,but D-D is the best indicatior.
作者
陈显荣
肖兵容
成浩
CHEN Xian-rong;XIAO Bing-rong;CHENG Hao(Department of Ultrasound,the First People's Hospital of Tianmen,Tianman,Hubei 431700,China;不详)
出处
《中国卫生检验杂志》
CAS
2020年第20期2489-2491,共3页
Chinese Journal of Health Laboratory Technology
