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目的:探讨血清总胆汁酸检测对各种肝病的临床参考价值。方法:对500例肝病患者包括急性肝炎、慢性肝炎、肝硬化、肝癌空腹血清进行总胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)检测,并对各种肝病检测项目进行阳性率分析。结果:急性肝炎三项检测指标都显著升高,阳性率达到100%。慢性肝炎患者随病情加重检测指标也不断升高。肝硬化TBA阳性率为92.9%,ALT阳性率为35.7%,ALP阳性率为38.6%。肝癌TBA阳性率为96.7%,ALT阳性率为36.7%,ALP阳性率为43.3%。TBA在急性肝炎、肝硬化和肝癌中阳性率明显比传统肝功能酶学指标阳性率高。结论:血清总胆汁酸水平是反映肝细胞损坏的灵敏指标,在肝病早期诊断、检测、治疗方面灵敏度和特异性比传统肝功能检测指标高。尤其对肝硬化及肝癌的早期诊断具有特殊的参考意义。
Objective: To investigate the clinical value of serum total bile acid test in various liver diseases. Methods: The levels of total bile acid (TBA), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) in 500 patients with liver disease, including acute hepatitis, chronic hepatitis, cirrhosis and hepatocellular carcinoma were measured. Hepatic disease detection project for the positive rate analysis. Results: Three indicators of acute hepatitis were significantly increased, the positive rate of 100%. Chronic hepatitis patients with increasing severity of detection indicators are also rising. The positive rate of TBA in liver cirrhosis was 92.9%, the positive rate of ALT was 35.7%, and the positive rate of ALP was 38.6%. The positive rate of TBA in hepatocellular carcinoma was 96.7%, the positive rate of ALT was 36.7%, and the positive rate of ALP was 43.3%. The positive rate of TBA in acute hepatitis, cirrhosis and hepatocellular carcinoma was significantly higher than that of traditional liver function enzymology index. Conclusion: The serum total bile acid level is a sensitive index to reflect the damage of hepatocytes. Sensitivity and specificity in the diagnosis, detection and treatment of liver diseases are higher than traditional liver function tests. Especially for the early diagnosis of liver cirrhosis and liver cancer has a special reference value.