本文關(guān)鍵詞： 乙型肝炎 血清高爾基蛋白 臨床意義　出處：《檢驗(yàn)醫(yī)學(xué)與臨床》2016年23期 　論文類型：期刊論文

【摘要】：目的探討乙肝患者血清高爾基蛋白(GP)73水平改變及其臨床意義。方法連續(xù)性納入2013年1月至2015年6月于鎮(zhèn)江市中西醫(yī)結(jié)合醫(yī)院就診的300例慢性乙肝病毒感染患者,根據(jù)病情分為乙肝病毒攜帶(HBV-C)組共50例,慢性乙肝(CHB)組共120例,乙肝相關(guān)肝硬化(LC)組共60例,乙肝相關(guān)肝細(xì)胞癌(HCC)組70例。比較各組之間血清GP73水平差異,并通過(guò)相關(guān)性分析和受試者工作特征曲線(ROC曲線)分析比較GP73對(duì)不同乙肝患者病變程度的診斷學(xué)價(jià)值。結(jié)果 CHB組、HCC組和LC組患者GP73水平分別為(117.3±12.8)、(181.5±21.7)、(263.2±33.4)ng/mL,均明顯高于HBV-C組患者的(39.2±3.5)ng/mL,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。HCC組和LC組患者GP73水平又明顯高于CHB組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。代償LC亞組GP73水平[(245.6±29.3)ng/mL]明顯低于失代償LC亞組[(279.5±39.6)ng/mL],差異有統(tǒng)計(jì)學(xué)意義(P0.05)。血清GP73水平與天門(mén)冬氨酸氨基轉(zhuǎn)移酶(r=0.554,P0.05)、丙氨酸氨基轉(zhuǎn)移酶(r=0.409,P0.05)、清蛋白(r=0.445,P0.05)、Child-pugh分級(jí)(r=0.609,P0.05)和失代償LC(r=0.722,P0.05)呈正相關(guān)。GP73對(duì)于CHB的ROC曲線下面積(AUC)為0.741,95%CI為0.519~0.813,cut off值為176.3ng/mL,敏感性為77.8%,特異性為77.2%;GP73對(duì)于HCC的AUC為0.749,95%CI為0.676~0.834,cut off值為232.0ng/mL,敏感性為78.0%,特異性為82.5%;GP73對(duì)于LC的AUC為0.738,95%CI為0.636~0.841,cut off值為292.2ng/mL,敏感性為74.4%,特異性為80.9%;GP73對(duì)于失代償性LC的AUC為0.802,95%CI為0.699~0.932,cut off值為319.3ng/mL,敏感性為84.2%,特異性為90.3%。結(jié)論 GP73可以作為一種較為敏感且特異性較高的肝臟標(biāo)記物,不但有助于早期診斷HCC和LC,還有助于輔助判斷LC患者肝功能代償狀態(tài)。
[Abstract]:Objective to investigate the changes of serum Golgi protein GPN73 level and its clinical significance in patients with hepatitis B. Methods300 patients with chronic hepatitis B virus infection who were admitted to Zhenjiang Integrated Chinese and Western Medicine Hospital from January 2013 to June 2015 were included in the study. According to the disease condition, there were 50 cases of HBV carrying HBV-C group, 120 cases of chronic hepatitis B hepatitis B group, 60 cases of hepatitis B associated cirrhosis group and 70 cases of hepatitis B associated hepatocellular carcinoma group. The diagnostic value of GP73 in patients with hepatitis B was compared by means of correlation analysis and operating characteristic curve (ROC curve). Results the GP73 levels in CHB group and LC group were 117.3 鹵12.8g / mL and 263.2 鹵33.4 ng / mL, respectively, which were significantly higher than those in HBV-C. The levels of GP73 in HCC group and LC group were significantly higher than those in CHB group. The level of GP73 in compensatory LC subgroup [245.6 鹵29.3 ng / mL] was significantly lower than that in decompensated LC subgroup [279.5 鹵39.6 ng / mL], and the difference was statistically significant (P 0.05). The serum GP73 level was significantly higher than that of aspartate aminotransferase r0.554P0.05. The area under the ROC curve of GP73 for CHB is 0.741g / 95CI is 0.519 / 0.813cut off = 176.3ngmL, the sensitivity is 77.8and the specificity is 77.2GP73 's AUC for HCC is 0.749c95Cis 0.676NgmL0.834 cut off is 232.0ngmL, sensitivity is 72.5GP73 / LC, the sensitivity is 72.5GP73 / LC, the sensitivity is 72.5GP73 / LC's AUC is 0.7389595 / ml, the sensitivity is 78.0ngmL, and the specificity is 82.5GP73 / LC's AUC = 0.7389595 / ml. For decompensated LC, the AUC value was 0.802 + 95 CI, the off value was 319.3ng / mL, the sensitivity was 84.2ng / mL, and the specificity was 74.40.Conclusion GP73 can be used as a sensitive and highly specific liver marker for the decompensated LC, and its sensitivity is 84.2ng / mL, and its specificity is 90.30.Conclusion GP73 can be used as a more sensitive and highly specific liver marker for decompensated LC, with a off value of 0.802ng / mL, a sensitivity of 84.2ng / mL and a specificity of 90.30.Conclusion GP73 can be used as a sensitive and highly specific liver marker. It is not only helpful for early diagnosis of HCC and LC, but also helpful to judge the compensatory state of liver function in patients with LC.
【作者單位】： 江蘇省鎮(zhèn)江市中西醫(yī)結(jié)合醫(yī)院檢驗(yàn)科;江蘇省鎮(zhèn)江市第一人民醫(yī)院檢驗(yàn)科;
【分類號(hào)】：R512.62;R446.1

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