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

柯叶芳; 高国生; 朱喆; 陈必成

doi:10.3969/j.issn.1001-5256.2018.04.013

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

DOI: 10.3969/j.issn.1001-5256.2018.04.013

1. 温州医科大学附属第一医院外科实验室
2. 浙江省宁波市妇女儿童医院检验科
3. 浙江省宁波市第二医院检验科
4. 浙江省宁波市第二医院输血科

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中图分类号: R512.62;R575.2
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出版历程
- 出版日期: 2018-04-20

Value of serum adenosine deaminase in diagnosis of marked liver fibrosis in patients with chronic hepatitis B virus infection

Surgical Laboratory, The First Affiliated Hospital of Wenzhou Medical University

摘要

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S0S4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S0S4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、1...
- 腺苷脱氨酶 /
- 肝炎,乙型,慢性 /
- 肝硬化 /
- 诊断
Abstract: Objective To investigate the value of serum adenosine deaminase (ADA) in the diagnosis of marked liver fibrosis in patients with chronic hepatitis B virus (HBV) infection.Methods A 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.Results There 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.Conclusion Serum ADA has a certain value in the diagnosis of marked liver fibrosis in patients with chronic HBV infection.
- adenosine deaminase /
- hepatitis B, chronic /
- liver cirrhosis /
- diagnosis

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