| 王 蓓,周 娜,牟 洋,马媛媛,许雅婷.腹部超声联合血清甲胎蛋白、高尔基体蛋白73、γ-谷氨酰转肽酶/血小板比值对慢性乙型肝炎患者肝纤维化的诊断价值研究[J].,2023,(5):892-897 |
| 腹部超声联合血清甲胎蛋白、高尔基体蛋白73、γ-谷氨酰转肽酶/血小板比值对慢性乙型肝炎患者肝纤维化的诊断价值研究 |
| Diagnostic Value Study of Abdominal Ultrasound Combined with Serum Alpha Fetoprotein, Golgi Protein 73, γ- Glutamyl Transpeptidase/Platelet Ratio in Patients with Chronic Hepatitis B Liver Fibrosis |
| 投稿时间：2022-06-24 修订日期：2022-07-20 |
| DOI：10.13241/j.cnki.pmb.2023.05.018 |
| 中文关键词: 慢性乙型肝炎 肝纤维化 腹部超声 甲胎蛋白 高尔基体蛋白73 γ-谷氨酰转肽酶/血小板比值 诊断价值 |
| 英文关键词: Chronic hepatitis B Liver fibrosis Abdominal ultrasound Alpha fetoprotein Golgi protein 73 γ-glutamyl transpeptidase/platelet ratio Diagnostic value |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2016D01C133） |
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| 中文摘要: |
| 摘要 目的：探讨腹部超声联合血清甲胎蛋白（AFP）、高尔基体蛋白73（GP73）、γ-谷氨酰转肽酶/血小板比值（GPR）对慢性乙型肝炎患者肝纤维化的诊断价值。方法：选择新疆维吾尔自治区中医医院2020年3月～2022年2月期间收治的慢性乙型肝炎患者148例，根据肝脏活检病理诊断结果分为无肝纤维化组39例、轻度肝纤维化组33例、中度肝纤维化组51例、重度肝纤维化组25例。比较各组患者入院后腹部超声检查结果及血清AFP、GP73、GPR，应用受试者工作特征（ROC）曲线分析腹部超声联合AFP、GP73、GPR对慢性乙型肝炎患者肝纤维化的诊断价值。结果：随着肝纤维化程度地增加，患者肝脏轮廓逐渐不清晰、表面不光滑、肝脏回声逐渐增粗增强、有结节感、肝内胆管走形逐渐模糊，脂肪肝和腹水比例逐渐增加，脾脏厚度、脾脏长度、门静脉内径、脾静脉内径逐渐增加，经单因素方差分析显示各组超声指标比较差异有统计学意义（P<0.05）。腹部超声对慢性乙型肝炎患者肝纤维化诊断的灵敏度为79.82%、特异度为76.92%、准确度为79.05%。随着肝纤维化程度的增加，患者血清AFP、GP73及GPR逐渐增加，差异均有统计学意义（P<0.05）。ROC曲线分析结果显示，血清AFP、GP73、GPR对慢性乙型肝炎患者肝纤维化诊断具有较高的曲线下面积（AUC），分别为0.701、0.664、0.779，腹部超声联合血清AFP、GP73、GPR对慢性乙型肝炎患者肝纤维化诊断的AUC最高（AUC为0.819）。结论：慢性乙型肝炎肝纤维化患者血清AFP、GP73、GPR升高，腹部超声联合血清AFP、GP73、GPR对慢性乙型肝炎患者肝纤维化具有较高的诊断价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the diagnostic value of abdominal ultrasound combined with serum alpha fetoprotein (AFP), Golgi protein 73 (GP73), γ- glutamyl transpeptidase/platelet ratio (GPR) in patients with chronic hepatitis B liver fibrosis. Methods: A total of 148 patients with chronic hepatitis B who were admitted to Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine from March 2020 to February 2022 were selected, and they were divided into non-liver fibrosis group with 39 cases, mild liver fibrosis group with 33 cases, moderate liver fibrosis group with 51 cases and severe liver fibrosis group with 25 cases according to the pathological diagnosis of liver biopsy. The results of abdominal ultrasound examination and serum AFP, GP73 and GPR were compared between the groups after admission. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of abdominal ultrasound combined with AFP, GP73 and GPR in patients with chronic hepatitis B liver fibrosis. Results: With the increase of the degree of liver fibrosis, the contour of the liver was gradually unclear, the surface was not smooth, the echo of the liver was gradually thickened and enhanced, there was a sense of nodulation, the shape of the intrahepatic bile duct was gradually blurred, the proportion of fatty liver and asastic fluid was gradually increased, the thickness of spleen, the length of spleen, the inner diameter of portal vein and the inner diameter of splenic vein were gradually increased. One-way analysis of variance showed that there were significant differences in ultrasound indicators among groups(P<0.05). The sensitivity of abdominal ultrasound in the diagnosis of patients with chronic hepatitis B liver fibrosis was 79.82%, the specificity was 76.92%, the accuracy was 79.05%. With the increase of the degree of liver fibrosis, serum AFP, GP73 and GPR increased gradually, and the differences were statistically significant(P<0.05). ROC curve analysis showed that serum AFP, GP73 and GPR had higher area under curve (AUC) for the diagnosis of patients with chronic hepatitis B, which were 0.701, 0.664 and 0.779, respectively. The AUC of abdominal ultrasound combined with serum AFP, GP73 and GPR for the diagnosis of patients with chronic hepatitis B liver fibrosis was the highest(AUC was 0.819). Conclusion: Serum AFP, GP73 and GPR are increased in patients with chronic hepatitis B liver fibrosis. Abdominal ultrasound combined with serum AFP, GP73 and GPR has high diagnostic value for patients with chronic hepatitis B liver fibrosis. |
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