摘要
目的观察甘胆酸(CG)在肝脏疾病中的变化情况,评估CG联合总胆汁酸(TBA)及亮氨酸氨基肽酶(LAP)对各类肝病的诊断价值。方法收集本院2016年10月至2017年3月健康体检者、无症状HBV携带者、肝炎患者、胆道梗阻患者、肝硬化患者及原发性肝癌患者血清样本共210例,分别采用相应试剂盒检测CG及LAP,同时收录患者肝功能、凝血功能等指标,并进行统计学分析。结果 CG水平在各肝病组中均有升高,与正常组及无症状HBV携带组比较差异均具有统计学意义(P<0.05);CG与LAP呈正相关(r=0.380,P<0.01);在肝功能指标中,CG与TB、DB、TBA及AKP等存在相关;在凝血常规中与Fib、TT等相关;多元线性回归分析CG的影响因素,最终引入的变量为LAP及TBA,回归方程为Y=-0.835+0.157X_1+0.312X_2(X_1:LAP;X_2:TBA,R^2=0.685);ROC曲线分析表明CG联合LAP诊断各组肝病的能力最强。结论 CG水平的变化在各种肝病中均具有重要意义,联合LAP诊断各组肝病的能力最强,具有较好的临床应用价值。
Objective To observe the changes of glycocholic acid (CG) and evaluate the diagnostic value of CG combined with total bile acid (TBA) and leucine aminopeptidase (LAP) in various liver diseases. Methods From October 2016 to March 2017, 210 serum samples of healthy people, asymptomatic hepatitis B virus (HBV) infected, hepatitis , biliary obstruction , hepatocirrhosis and primary hepatocellular carcinoma patients were collected. CG and LAP were detected by corresponding kits, and liver function, coagulation function and other indicators of patients were collected and analyzed statistically. Results The serum level of CG were elevated in the 4 liver disease groups and differed statistically from the normal group or the asymptomatic HBV infected group. CG level was positively correlated with LAP (r=0.380, P<0.01). In liver function indexes, CG was correlated with total bilirubin(TB), direct bilirubin (DB), TBA and alkaline phosphatase (AKP). At the same time, CG was correlated with fibrinogen(Fib), thrombin time(TT). LAP and TBA were introduced into regression equation Y=-0.835+ 0.157X1+ 0.312X2 (X1: LAP, X2: TBA, R^2=0.685) as final variables in multivariate linear regression to analyse the influencing factors of CG. Receiver operator characteristic (ROC) curve analysis showed that CG had the strongest ability to diagnose liver diseases in combination with LAP. Conclusions The change of CG level is of great significance in all kinds of liver diseases. The combination of LAP has the strongest ability to diagnose liver diseases.
作者
梁运来
谢旭林
任煜培
马雅婷
王堃
易斌
Liang Yunlai;Xie Xulin;Ren Yupei;Ma Yat in g;Wang Kun;Yi Bin(Department of Clinical hibordtory, Xiangya Hospital of Central South Unirersitv, Changsha 410008, Chirm)
出处
《中国医师杂志》
CAS
2019年第3期387-391,共5页
Journal of Chinese Physician
关键词
甘胆酸
亮氨酰氨肽酶
胆汁酸类和盐类
肝疾病
Glycocholic acid
Leucyl aminopeptidase
Bile acids and salts
Liver diseases
作者简介
通信作者:易斌.Email:xyyibin@163.com.
