摘要
目的:探究血清甲胎蛋白异质体3(AFP-L3)和甲状腺激素水平检测乙型肝炎相关肝病的临床价值。方法:选取2018年9月至2020年1月于我院诊治的慢性乙型肝炎、乙型肝炎肝硬化、乙型肝炎相关肝癌患者各30例,分为慢性肝炎组、肝硬化组、肝癌组。同时选取同期于我院体检的健康志愿者30例,设为对照组。所有患者入院时均进行血清AFP-L3和血清甲状腺激素[血清游离T3(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、总T3(TT3)、以及总甲状腺素(TT4)]水平检测,分析4组人员血清AFP-L3和血清甲状腺激素水平的差异,及肝硬化组患者相关指标的差异。采用受试者工作曲线(ROC)分析血清AFP-L3和血清甲状腺激素水平在乙型肝炎相关肝病临床诊断中的价值。结果:慢性肝炎组、肝硬化组、肝癌组患者血清AFP-L3、TSH水平显著高于对照组(P<0.05),血清FT3、FT4、TT3、TT4水平显著低于对照组(P<0.05)。肝癌组患者血清AFP-L3显著高于慢性肝炎组、肝硬化组(P<0.05),FT3水平显著低于慢性肝炎组、肝硬化组(P<0.05)。肝硬化组患者血清AFP-L3水平显著高于慢性肝炎组(P<0.05),血清FT3、FT4、TT3、TT4水平显著低于慢性肝炎组(P<0.05)。30例肝硬化患者中代偿期19例,失代偿期11例。失代偿患者血清AFP-L3显著高于代偿组(P<0.05),血清FT3水平显著低于代偿组(P<0.05)。血清AFP-L3、FT3水平诊断肝癌的最优临界值分别为27.8 IU/mL、3.3 pmol/L,AUC分别为0.763(0.621,0.920)、0.628(0.549,0.879)。血清AFP-L3、FT3具有肝硬化诊断价值(AUC>0.5),血清FT4、TT3、TT4水平无诊断价值(AUC<0.5)。血清AFP-L3、FT3水平诊断肝硬化的最优临界值分别为8.9 IU/mL、3.7 pmol/L,AUC分别为0.721(0.601,0.912)、0.523(0.512,0.890),联合检测的AUC(95%CI)=0.758(0.532,0.884)。血清AFP-L3、FT3水平诊断乙型肝炎肝硬化失代偿的最优临界值分别为11.5 IU/mL、3.6 pmol/L,AUC分别为0.625(0.503,0.712)、0.531(0.420,0.698),
Objective:To explore the clinical value of serum alpha-fetoprotein variants(AFP-L3)and thyroid hormone levels in detecting hepatitis B-related liver diseases.Methods:A total of 30 patients with chronic hepatitis B,hepatitis B cirrhosis,and hepatitis B-related liver cancer diagnosed and treated in our hospital from September 2018 to January 2020 were selected and named respectively as hepatitis B group,cirrhosis group,and liver cancer group.Thirty healthy volunteers who were admitted to our hospital for physical examination during the same period were selected and named the control group.All patients were tested for serum AFP-L3 and serum thyroid hormone levels at admission.Serum thyroid hormones included serum free T3(FT3),free thyroxine(FT4)and thyroid stimulating hormone(TSH)levels,and total T3(TT3)And total thyroxine(TT4)levels.The differences in serum AFP-L3 and serum thyroid hormone levels in the four groups of patients were analyzed,and the differences in related indicators of patients in the liver cirrhosis group were analyzed.Receiver operating curve(ROC)was used to analyze the value of serum AFP-L3 and serum thyroid hormone levels in the clinical diagnosis of hepatitis B-related liver disease.Results:Serum AFP-L3 and TSH levels of patients in the hepatitis B group,liver cirrhosis group,and liver cancer group were significantly higher than that of the control group(P<0.05),and serum FT3,FT4,TT3,and TT4 levels were significantly lower than the control group(P<0.05).Serum AFP-L3 in the liver cancer group was significantly higher than that in the hepatitis B group and cirrhosis group(P<0.05),and FT3 level was significantly lower than that in the hepatitis B group and cirrhosis group(P<0.05).Serum AFP-L3 levels in the liver cirrhosis group were significantly higher than those in the hepatitis B group(P<0.05),serum FT3,FT4,TT3,TT4 levels were significantly lower than those in the hepatitis B group(P<0.05).Among the 30 patients with hepatitis B cirrhosis,there were 19 cases of compensation period and 11 cases o
作者
韦柯利
黄杰安
袁海宁
刘诗权
邹军
姚莉
周利艳
于冰
WEI Ke-li;HUANG Jie-an;YUAN Hai-ning;YU Bing(Department of infectious diseases,the Second Affiliated Hospital of Guangxi Medical University(Nanning Guang xi,530000),China)
出处
《中西医结合肝病杂志》
CAS
2021年第5期413-417,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
广西医科大学第二附属医院2019年度国家自然科学基金培育项目(No.GJPY2019005)
。
关键词
肝炎
乙型
慢性
肝硬化
肝癌
甲胎蛋白异质体3
甲状腺激素
chronic hepatitis B
cirrhosis
liver cancer
alpha-fetoprotein heterogeneity 3
thyroid hormone
