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目的探讨血清纤维化指标联合肝功能指标诊断肝硬化的临床价值。方法随机选择2016年1月至2017年1月收治的74例肝硬化患者作为研究对象,肝硬化静止期和肝硬化活动期各37例,另选择50例健康人作为对照,进行肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)]及血清纤维化指标[透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)和Ⅳ型胶原(Ⅳ-C)]。结果肝硬化组患者血清HA、LN、PC-Ⅲ、Ⅳ-C、ALT、AST明显高于对照组(P<0.01)。肝硬化活动期患者HA、LN、PC-Ⅲ、Ⅳ-C、ALT、AST明显高于肝硬化静止期患者(P<0.01)。HA与ALT(r=0.931)、LN与ALT(r=0.786)、PC-Ⅲ与ALT(r=0.842)、Ⅳ-C与ALT(r=0.631)、HA与AST(r=0.625)、LN与AST(r=0.568)、PC-Ⅲ与AST(r=0.624)、Ⅳ-C与AST(r=0.497)呈明显正相关性(P<0.05)。结论血清纤维化指标联合肝功能指标检测对肝硬化诊断具有较高临床价值,也能为鉴别肝硬化静止期及活动期提供依据,动态监测二者变化情况至关重要。
Objective To investigate the clinical value of serum fibrosis markers combined with liver function in the diagnosis of liver cirrhosis. Methods A total of 74 patients with cirrhosis admitted from January 2016 to January 2017 were enrolled in this study. 37 patients with quiescent liver cirrhosis and cirrhosis and 50 healthy controls were selected as control group, (ALT), aspartate aminotransferase (AST) and serum fibrosis index (HA, laminin, PC-Ⅲ) And type Ⅳ collagen (Ⅳ-C)]. Results The serum levels of HA, LN, PC-Ⅲ, Ⅳ-C, ALT and AST in patients with cirrhosis were significantly higher than those in the control group (P <0.01). The levels of HA, LN, PC-Ⅲ, Ⅳ-C, ALT and AST in patients with cirrhosis were significantly higher than those in patients with cirrhosis (P <0.01). HA and AST (r = 0.625), LN and ALT (r = 0.786), PC-Ⅲ and ALT (r = There was a significant positive correlation between AST and AST (r = 0.568), PC-Ⅲ and AST (r = 0.624), Ⅳ-C and AST (r = 0.497) (P <0.05). Conclusion Serum fibrosis markers combined with liver function tests have high clinical value in the diagnosis of cirrhosis, and can also provide evidence for the identification of quiescent and active stages of cirrhosis. It is very important to dynamically monitor the changes of both.