乙肝患者血清高尔基蛋白73水平改变及其临床意义

发布时间：2018-02-25 23:32

本文关键词： 乙型肝炎血清高尔基蛋白临床意义　出处：《检验医学与临床》2016年23期 　论文类型：期刊论文

【摘要】：目的探讨乙肝患者血清高尔基蛋白(GP)73水平改变及其临床意义。方法连续性纳入2013年1月至2015年6月于镇江市中西医结合医院就诊的300例慢性乙肝病毒感染患者,根据病情分为乙肝病毒携带(HBV-C)组共50例,慢性乙肝(CHB)组共120例,乙肝相关肝硬化(LC)组共60例,乙肝相关肝细胞癌(HCC)组70例。比较各组之间血清GP73水平差异,并通过相关性分析和受试者工作特征曲线(ROC曲线)分析比较GP73对不同乙肝患者病变程度的诊断学价值。结果 CHB组、HCC组和LC组患者GP73水平分别为(117.3±12.8)、(181.5±21.7)、(263.2±33.4)ng/mL,均明显高于HBV-C组患者的(39.2±3.5)ng/mL,差异均有统计学意义(P0.05)。HCC组和LC组患者GP73水平又明显高于CHB组,差异有统计学意义(P0.05)。代偿LC亚组GP73水平[(245.6±29.3)ng/mL]明显低于失代偿LC亚组[(279.5±39.6)ng/mL],差异有统计学意义(P0.05)。血清GP73水平与天门冬氨酸氨基转移酶(r=0.554,P0.05)、丙氨酸氨基转移酶(r=0.409,P0.05)、清蛋白(r=0.445,P0.05)、Child-pugh分级(r=0.609,P0.05)和失代偿LC(r=0.722,P0.05)呈正相关。GP73对于CHB的ROC曲线下面积(AUC)为0.741,95%CI为0.519~0.813,cut off值为176.3ng/mL,敏感性为77.8%,特异性为77.2%;GP73对于HCC的AUC为0.749,95%CI为0.676~0.834,cut off值为232.0ng/mL,敏感性为78.0%,特异性为82.5%;GP73对于LC的AUC为0.738,95%CI为0.636~0.841,cut off值为292.2ng/mL,敏感性为74.4%,特异性为80.9%;GP73对于失代偿性LC的AUC为0.802,95%CI为0.699~0.932,cut off值为319.3ng/mL,敏感性为84.2%,特异性为90.3%。结论 GP73可以作为一种较为敏感且特异性较高的肝脏标记物,不但有助于早期诊断HCC和LC,还有助于辅助判断LC患者肝功能代偿状态。
[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 卤12.8g / mL and 263.2 卤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 卤29.3 ng / mL] was significantly lower than that in decompensated LC subgroup [279.5 卤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.
【作者单位】：江苏省镇江市中西医结合医院检验科;江苏省镇江市第一人民医院检验科;
【分类号】：R512.62;R446.1

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