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ALT水平对乙型肝炎肝硬化患者肝脏硬度值的影响
文章发布日期:2018年07月06日  来源:  作者:周家玲,吴晓宁,孙亚朦,等  点击次数:495次  下载次数:91次

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【摘要】:目的探讨ALT水平对乙型肝炎肝硬化肝脏硬度值(LSM)分布的影响。方法选取2012年1月-2015年5月在北京友谊医院及各分中心经肝穿刺诊断为乙型肝炎肝硬化的初治患者,收集入组患者的人口学特征、血常规、生化、HBV DNA、AFP、LSM、腹部超声和肝穿刺资料。比较乙型肝炎肝硬化患者中不同ALT水平的LSM分布特征。组间比较采用单因素方差分析或Kruskal-Wallis H检验,计数资料组间比较采用χ2检验,相关性分析采用Pearson相关和偏相关。结果共入组104例患者,根据ALT水平分成3组[≤2倍正常值上限(ULN)、2~5 ULN和 ≥5 ULN],3组在性别构成比、BMI、HBeAg状态、HBV DNA水平、Alb水平、PLT方面差异均无统计学意义(P值均>0.05)。3组患者的LSM中位值分别为15.4、18.8及29.9 kPa,LSM随着ALT升高而升高,3组间差异有统计学意义(χ2= 10.07,P<0.05)。校正年龄后乙型肝炎肝硬化患者的LSM与ALT仍呈正相关(r=0.220, 95%可信区间: 0.101~0.468,P<0.05)。结论在乙型肝炎肝硬化患者中,LSM随着ALT升高而升高,患者年龄在不同ALT水平组间有差异,而校正年龄因素后,LSM与ALT之间仍存在正相关关系。
【Abstract】:ObjectiveTo investigate the effect of alanine aminotransferase (ALT) level on liver stiffness measurement (LSM) in patients with hepatitis B cirrhosis. MethodsThe patients who were diagnosed with hepatitis B cirrhosis by liver biopsy in Beijing Friendship Hospital from January 2012 to May 2015 and did not receive antiviral therapy were enrolled. Their demographic characteristics, routine blood test results, biochemical parameters, hepatitis B virus (HBV) DNA level, alpha-fetoprotein level, LSM, abdominal ultrasound findings, and liver biopsy data were collected. LSM was compared between hepatitis B cirrhosis patients with different ALT levels. The one-way analysis of variance or rank sum test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data. Pearson correlation analysis and partial correlation analysis were performed. ResultsA total of 104 patients were recruited and divided into three groups according to their ALT levels (≤2×upper limit of normal [ULN], 2-5×ULN, and ≥5×ULN). There were no significant differences between the three groups in sex ratio, body mass index, HBeAg status, HBV DNA level, albumin level, and platelet count (all P>0.05). The median values of LSM for the three groups were 15.4 kPa, 18.8 kPa, and 29.9 kPa, respectively, suggesting that LSM increased as the ALT level increased, and there was a significant difference in LSM between the three groups (χ2=10.07, P<0.05). After adjusting for age, which was significantly different between the three groups, LSM was still found to be positively correlated with ALT level (r=0.220, 95% confidence interval: 0.101-0.468, P<0.05). ConclusionIn patients with hepatitis B cirrhosis, LSM increased with the increasing ALT level, and the positive correlation remains after adjusting for age.
【关键字】:肝硬化; 肝炎, 乙型, 慢性; 丙氨酸转氨酶; 肝脏硬度值
【Key words】:liver cirrhosis; hepatitis B, chronic; alanine transaminase; liver stiffness measurement
【引证本文】:ZHOU JL, WU XN, SUN YM, et al. Effect of ALT level on liver stiffness measurement in patients with hepatitis B cirrhosis[J]. J Clin Hepatol, 2018, 34(8): 1674-1677. (in Chinese)
周家玲, 吴晓宁, 孙亚朦, 等. ALT水平对乙型肝炎肝硬化患者肝脏硬度值的影响[J]. 临床肝胆病杂志, 2018, 34(8): 1674-1677.

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