摘要
目的了解视黄醇结合蛋白（RBP）、前白蛋白（PA）、天门冬氨酸氨基转移酶线粒体同工酶（m-AST）、纤维结合蛋白（FN）、腺苷脱氨酶（ADA）5项指标在肝病诊断和治疗中的意义。方法使用日立7180全自动生化分析仪测定132例急性肝炎、16例重型肝炎、32例肝硬化、35例酒精性肝炎、68例慢性肝炎和92例健康对照者的血清m-AST、RBP、PA、FN、ADA水平。绘制5项指标在不同肝病中的受试者工作特征（ROC）曲线,并计算ROC曲线下面积（AUC）。结果急性肝炎组和重型肝炎组m-AST、ADA显著增高,RBP、FN、PA显著降低;m-AST的异常比例最高（均为100%）;m-AST、RBP、PA的AUC较高,分别为0.94、0.90、0.85和0.96、0.92、0.87。肝硬化组ADA升高,m-AST轻度升高,RBP、PA、FN降低;FN的异常比例最高（100%）;FN的AUC为0.88,ADA为0.66,其他3项仅为0.46~0.47。酒精性肝炎组m-AST轻度升高,FN显著下降,其余项目均变化不大,m-AST、FN异常比例较高（98%、81%）;m-AST的AUC为0.86,其他4项的AUC均较低。慢性肝炎组中以m-AST升高最为明显,5项指标的异常比例均≤60%,各指标的AUC也较低。结论急性肝炎中m-AST、RBP、ADA、PA、FN均有应用价值;重型肝炎中m-AST、RBP、PA应用价值较大;肝硬化中FN、ADA有应用价值;酒精性肝炎m-AST轻度升高,能区别于慢性肝炎。
Objective To discuss the diagnostic and prognostic values of serum mitochondrial aspartate amino transferase（m-AST）,retinol binding protein（RBP）,pre-albumin（PA）,adenosine deaminase（ADA） and fibronectin（FN） in patients with liver diseases.Methods The levels of m-AST,RBP,PA,ADA and FN in 132 patients with acute hepatitis,16 patients with severe hepatitis,32 patients with cirrhosis,35 patients with alcoholic hepatitis,68 patients with chronic hepatitis and 92 healthy controls were determined by Hitachi 7180 auto analyzer.The receiver operating characteristic（ROC） curves were created from the results for the calculating of the area under the ROC curve（AUC）.Results The levels of m-AST and ADA in patients with acute hepatitis and severe hepatitis were higher than those in healthy controls and the levels of RBP,FN and PA were lower.The anomaly ratio of m-AST was 100%;AUC of m-AST,RBP and PA in acute hepatitis and severe hepatitis were 0.94,0.90,0.85 and 0.96,0.92,0.87 respectively.The level of ADA in liver cirrhosis patients was significantly higher and m-AST was slightly higher than that in healthy controls and the levels of RBP,PA,FN were lower.The anomaly ratio of FN was 100% and its AUC was 0.88,0.66 of ADA,and the others were 0.46-0.47.In alcoholic hepatitis group,m-AST was higher slightly,and FN was lower and the others change slightly.The anomaly ratio of m-AST and FN was high at 98% and 81%;the AUC of m-AST was 0.86 and the others were lower.The m-AST was significantly higher in the chronic hepatitis group,and the anomaly ratios of other values were lower than 60%.All values of AUC were lower.Conclusions The m-AST,RBP,ADA,PA and FN are all valuable markers for acute hepatitis.The m-AST,RBP and PA are valuable in severe hepatitis.The FN and ADA are valuable markers for liver cirrhosis.The m-AST is slightly higher in alcoholic hepatitis and can be used to differentiate with chronic hepatitis.
出处
《检验医学》
CAS
北大核心
2009年第12期886-888,共3页
Laboratory Medicine
