The contrast study of serum liver fibrosis indexes and liver pathology
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摘要: 评价血清肝纤维化指标诊断肝纤维化病理分期的临床价值。 6 9例肝穿确诊的慢性乙型病毒性肝炎患者 ,同时进行血清HA、Ⅳ -C、PⅢP、LN的检测。以肝活检组织纤维化病理分期为金标准对以上血清学指标的诊断价值进行分析。HA、Ⅳ -C、PⅢP、LN与纤维化分期的相关系数分别为 0 30 2 (P <0 0 1)、0 6 6 3(P <0 0 1)、0 346 (P<0 0 5 )、0 0 5 6 (P >0 0 5 )。除LN外 ,其余指标血清水平均随着肝纤维化程度的加重而逐渐上升 ,其中HA、Ⅳ -C、PⅢPS3 、S4期血清水平与S1期比较有统计学差异 (P <0 0 1)。S4作为早期肝硬化诊断标准时 ,通过ROC曲线分析HA、Ⅳ -C、PⅢP、LN的曲线下面积分别为 0 74 5、0 90 9、0 732、0 4 2 5。敏感度Ⅳ -C >PⅢP >HA >LN ;特异度HA >Ⅳ -C >PⅢP >LN。血清肝纤维化指标对肝脏纤维化程度的判断有一定的指导意义。Abstract: To evaluate the clinical value of serum fibrosis index in the diagnosis of hepatic fibrosis. 69serum samples from patients with chronic hepatitis B were detected by RIA and EIA for fibrosis indexes including HA, PⅢP, LN and Ⅳ-C. liver biopsy were performed in all patients. Ⅳ-C, HA, PⅢP correlate positively with stage of fibrosis (r=0.663 P<0.01;r=0.302 P<0.01;r=0.346 P<0.05) 。ROC analysis showed that the AUCs of HA, Ⅳ-C, PⅢP, and LN were 0.745、0.909、0.732、0.425, respectively, when S=4 as positive criteria for diagnosing early liver cirrhosis. The sensitivity Ⅳ-C>PⅢP>HA>LN, the specificity HA>Ⅳ-C>PⅢP>LN. Serum fibrosis index can predict the tendency of hepatic fibrosis.
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[1]贾继东, 尹姗姗.肝纤维化的诊断和治疗进展[J].临床内科杂志, 2002, 19 (4) ∶244-246. [2]郑敏, 蔡卫民, 翁红雷, 等.ROC曲线评价血清纤维化指标在诊断肝纤维化的价值[J].中华传染病杂志, 2002, 20∶225-227.
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