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血清腺苷脱氨酶对慢性HBV感染者显著肝纤维化的诊断价值
Value of serum adenosine deaminase in diagnosis of marked liver fibrosis in patients with chronic hepatitis B virus infection
文章发布日期:2018年03月07日  来源:  作者:柯叶芳,高国生,朱喆,等  点击次数:382次  下载次数:54次

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【摘要】:目的探讨血清腺苷脱氨酶(ADA)诊断慢性HBV感染者显著肝纤维化的价值。方法选取2011年5月-2016年10月在宁波市第二医院接受肝活组织检查的493例慢性HBV感染者,根据肝纤维化程度将所有患者分为S0~S4级,S0级79例,S1级254例,S2级103例,S3级35例,S4级22例。常规检测TBil、ALT、AST、ALP、GGT、Alb、ADA等生化指标和血常规指标,计算AST/PLT比值指数(APRI)。比较不同分级患者各指标的差异。正态分布的计量资料多组间比较采用方差分析,偏态分布计量资料组间比较采用Kruskal-Wallis H检验。计数资料组间比较采用χ2检验。对各指标进行二分类logistic回归,采用受试者工作特征曲线(ROC曲线)分析ADA、APRI单独及多指标联合应用对显著肝纤维化(S≥2)的诊断价值。结果年龄、性别、TBil、ALT、AST、ALP、GGT、Alb、ADA和APRI在S0~S4级肝纤维化患者中比较,差异均有统计学意义(F=11.41, χ2值分别为14.45、1508、28.27、48.22、48.65、80.53、17.03、57.89、73.20,P值均<0.05)。性别、年龄和血清ADA是显著肝纤维化的独立危险因素(比值比分别为2.59、1.05、112,P值均<0.01)。ADA、APRI及多指标联合应用诊断显著肝纤维化均有一定价值(P值均<0.01),ROC曲线下面积分别为070、0.73和0.75。结论血清ADA对慢性HBV感染者显著肝纤维化有一定的辅助诊断价值。
【Abstract】:ObjectiveTo investigate the value of serum adenosine deaminase (ADA) in the diagnosis of marked liver fibrosis in patients with chronic hepatitis B virus (HBV) infection. MethodsA total of 493 patients with chronic HBV infection who underwent liver biopsy in Ningbo No. 2 Hospital from May 2011 to October 2016 were enrolled, and according to the degree of liver fibrosis, these patients were divided into S0 group with 79 patients, S1 group with 254 patients, S2 group with 103 patients, S3 group with 35 patients, and S4 group with 22 patients. Biochemical parameters including total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), albumin (Alb), and ADA were measured, routine blood test was performed, and aspartate aminotransferase-to-platelet ratio index (APRI) was calculated. These indices were compared between groups. An analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between groups. The chi-square test was used for comparison of categorical data between groups. A dichotomous logistic regression analysis was performed for these indices, and the receiver operating characteristic (ROC) curve was used to analyze the value of ADA, APRI, or a combination of various indices in the diagnosis of marked liver fibrosis. ResultsThere were significant differences in age, sex, TBil, ALT, AST, alkaline phosphatase, GGT, Alb, ADA, and APRI between the S0, S1, S2, S3, and S4 groups (F=11.41, χ2=14.45, 15.08, 28.27, 48.22, 48.65, 80.53, 17.03, 57.89, and 73.20, all P<0.05). Sex, age, and serum ADA were independent risk factors for marked liver fibrosis (odds ratio = 2.59, 1.05, and 1.12, all P<0.01). ADA, APRI, or a combination of various indices had a certain value in the diagnosis of marked liver fibrosis (all P<0.01), with an area under the ROC curve of 0.70, 0.73, and 0.75, respectively. ConclusionSerum ADA has a certain value in the diagnosis of marked liver fibrosis in patients with chronic HBV infection.
【关键字】:腺苷脱氨酶; 肝炎, 乙型, 慢性; 肝硬化; 诊断
【Key words】:adenosine deaminase; hepatitis B, chronic; liver cirrhosis; diagnosis
【引证本文】:KE YF, GAO GS, ZHU Z, et al. Value of serum adenosine deaminase in diagnosis of marked liver fibrosis in patients with chronic hepatitis B virus infection[J]. J Clin Hepatol, 2018, 34(4): 760-763. (in Chinese)
柯叶芳, 高国生, 朱喆, 等. 血清腺苷脱氨酶对慢性HBV感染者显著肝纤维化的诊断价值[J]. 临床肝胆病杂志, 2018, 34(4): 760-763.

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