摘要
目的 探讨同型半胱氨酸(Hcy)和脂联素(Apn)联合叶酸(FA)检测在肝脏疾病诊疗中的应用。方法 应用回顾性研究模型,选择2020年1月—2022年6月于常州市新北区奔牛人民医院住院的205例肝病患者作为研究对象,根据疾病类型分组,50例慢性乙型肝炎患者纳入肝炎组,50例肝纤维化患者纳入肝纤维化组,55例肝硬化患者纳入肝硬化组(其中26例为肝硬化代偿期患者,29例为肝硬化失代偿期患者),50例原发性肝癌患者纳入肝癌组;另外将同期在本院进行健康体检的50名人员纳入对照组。所有受检者均进行血清Hcy、Apn以及FA测定,比较患有不同肝脏疾病者以上指标的水平差异;采用受试者工作特征曲线(ROC曲线)并对曲线下面积(AUC)进行计算,比较不同指标单独或联合应用的诊断效能。结果 肝癌组的血清Hcy、Apn水平均明显高于肝纤维化组、肝炎组和对照组,FA水平均明显低于肝硬化组、肝纤维化组、肝炎组和对照组[Hcy(μmol/L):20.92(12.96,25.50)比15.05(11.61,17.34)、12.24(11.49,13.96)、10.87(9.48,13.08),Apn(mg/L):23.04(8.33,44.42)比9.95(5.53,11.27)、6.68(3.90,8.24)、4.10(3.38,5.94),FA(nmol/L):5.34(4.04,8.64)比8.57(5.23,10.95)、10.93(8.64,13.53)、11.09(10.35,12.47)、13.49(9.60,18.04),均P<0.05]。肝硬化组Hcy、Apn水平均明显高于肝炎组和对照组,FA水平明显低于肝纤维化组、肝炎组和对照组,差异均有统计学意义。肝纤维化组Hcy、Apn水平均明显高于肝炎组和对照组,FA水平明显低于对照组,差异均有统计学意义。肝炎组Hcy、Apn水平均明显高于对照组,FA水平明显低于对照组,差异均有统计学意义。肝硬化失代偿期组的Hcy、Apn水平均明显高于肝硬化代偿期组,FA水平明显低于肝硬化代偿组[Hcy(μmol/L):18.76(12.74,24.43)比14.76(12.18,16.58),Apn(mg/L):26.60(7.11,37.35)比9.72(5.78,26.53),FA(nmol/L):7.17(5.17,9.75)比10.19(5.47,11.51),均P<0.05]。Apn诊断肝硬化的AUC最大,为0.898[95%可�
Objective To investigate the application of homocysteine(Hcy),adiponectin(Apn)combined with folic acid(FA)in the diagnosis and treatment of liver diseases.Methods Using retrospective research model,205 patients with liver diseases admitted to Changzhou Xinbei District Benniu People's Hospital from January 2020 to June 2022 were selected as research objects.Grouped by disease type,50 patients with chronic hepatitis B were included in hepatitis group,50 patients with hepatic fibrosis were included in hepatic fibrosis group,55 patients with cirrhosis were included in cirrhosis group(26 patients with compensatory cirrhosis,29 patients with decompensated cirrhosis),and 50 patients with primary liver cancer were included in liver cancer group.Other 50 healthy physical examinees during the same period were selected as control group.All subjects were tested for serum Hcy,Apn and FA,and the differences of above indicators among patients with different liver diseases were compared.The receiver operator characteristic(ROC)curve was drawn,the area under ROC curve(AUC)was calculated,and the diagnostic efficacies of individual and combined detection of indicators in liver diseases were compared.Results The serum Hcy and Apn levels in liver cancer group were higher than those in liver fibrosis group,hepatitis group and control group,while the FA level was lower than those in cirrhosis group,liver fibrosis group,hepatitis group and control group[Hcy(μmol/L):20.92(12.96,25.50)vs.15.05(11.61,17.34),12.24(11.49,13.96),10.87(9.48,13.08),Apn(mg/L):23.04(8.33,44.42)vs.9.95(5.53,11.27),6.68(3.90,8.24),4.10(3.38,5.94),FA(nmol/L):5.34(4.04,8.64)vs.8.57(5.23,10.95),10.93(8.64,13.53),11.09(10.35,12.47),13.49(9.60,18.04),all P<0.05].The Hcy and Apn levels in cirrhosis group were higher than those in hepatitis group and control group,while the FA level was lower than those in liver fibrosis group,hepatitis group and control group,with statistically significant differences.The Hcy and Apn levels in liver fibrosis group were higher than those
作者
吴自权
史黎黎
周埼
屠亚飞
贡利娟
Wu Ziquan;Shi Lili;Zhou Qi;Tu Yafei;Gong Lijuan(Department of Clinical Laboratory,Changzhou Xinbei District Benniu People's Hospital,Changzhou 213000,Jiangsu,China)
出处
《实用检验医师杂志》
2023年第1期69-74,共6页
Chinese Journal of Clinical Pathologist
基金
国家重点研发计划重点专项(2019YFF0216502)。
关键词
同型半胱氨酸
脂联素
叶酸
肝脏疾病
诊断
Homocysteine
Adiponectin
Folic acid
Liver disease
Diagnosis
