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目的分析不同阶段HBV相关肝病患者外周血高尔基体糖蛋白73(GP73)水平和血小板(PLT)计数,了解二者对不同发病阶段HBV相关肝病的检测意义。方法收集2010年5月-2013年8月于北京佑安医院就诊的36例慢性乙型肝炎(CHB)、32例肝硬化和147例肝硬化后肝细胞癌(HCC)患者外周血标本,利用ELISA检测GP73水平,用全自动血细胞分析仪检测PLT。计量资料多组间比较用单因素方差分析,计数资料组间比较采用χ2检验,相关性分析用一元线性回归。结果在CHB、肝硬化、肝硬化基础上的HCC早早期、早期、进展期和晚期患者外周血浆中GP73水平和PLT均呈现出相同的变化趋势,HCC早早期患者的GP73水平[(80.5±49.8)ng/ml]和PLT计数[(84.4±40.0)×109/L]均显著低于CHB[(135.5±95.8)ng/ml,(174.4±49.9)×109/L]、HCC进展期[(133.8±71.1)ng/ml,(122.0±70.50)×109/L]和HCC晚期[(192.2±98.1)ng/ml,(176.2±86.3)×109/L],且差异均有统计学意义(P值均<0.01)。结论 GP73水平和PLT计数在HBV相关肝病的不同阶段呈现动态变化,联合动态检测GP73水平和PLT计数更有利于对早期HCC的鉴别诊断以及HCC预后的判断。
Objective To analyze the levels of peripheral blood GP73 and platelet count (PLT) in patients with HBV-related liver disease in different stages and to find out the significance of the two in detection of HBV-related liver disease in different stages. Methods Peripheral blood samples of 36 patients with chronic hepatitis B (CHB), 32 patients with cirrhosis and 147 patients with hepatocellular carcinoma (HCC) after liver cirrhosis were collected from May 2010 to August 2013 in Beijing You’an Hospital. GP73 level was detected by ELISA and PLT was detected by automatic hematology analyzer. Measurement data were compared between groups by one-way analysis of variance, count data between groups using χ2 test, correlation analysis using a linear regression. Results The plasma levels of GP73 and PLT in early, early, advanced and advanced HCC patients showed the same trend on the basis of CHB, cirrhosis and cirrhosis. The GP73 level of early HCC patients [(80.5 ± 49.8) ) were significantly lower than those of CHB [(135.5 ± 95.8) ng / ml and (174.4 ± 49.9) × 109 / L], respectively 133.8 ± 71.1 ng / ml, 122.0 ± 70.50 × 109 / L and 192.2 ± 98.1 ng / ml, 176.2 ± 86.3 × 109 / L, respectively) P <0.01). Conclusions GP73 level and PLT count show dynamic changes at different stages of HBV-related liver disease. Combined detection of GP73 level and PLT count is more beneficial for the differential diagnosis of early stage HCC and the prognosis of HCC.