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目的研究血清谷氨酰转移酶(GGT)水平与GGT/ALT、AST/ALT的比值联合分析对AFP阴性原发性肝癌的诊断价值。方法选取感染科住院治疗的AFP阴性原发性肝癌患者99例作为研究组(A组),同期住院的AFP阴性的乙型肝炎后肝硬化患者97例(B组)、慢性乙型肝炎患者189例(C组)作为对照组进行研究,并对各组患者GGT水平及GGT/ALT、AST/ALT比值进行比较分析。结果 A组、B组、C组患者GGT水平分别为(109.59±111.06)U/L、(51.99±55.00)U/L、(86.76±69.27)U/L,A组与其他两组比较,差异有统计学意义(P<0.01)。AST/ALT比值分别为:1.55±1.02、1.07±0.56、0.51±0.29,A组与其他两组比较,差异有统计学意义(P<0.01)。GGT/ALT比值分别为:3.43±3.12、0.78±0.30、0.46±0.79,A组与其他两组比较,差异有统计学意义(P<0.01)。结论在慢性乙型肝炎,乙肝后肝硬化患者,肝功能检查如表现为:GGT升高,且GGT>ALT、AST>ALT时,即使AFP阴性,亦应高度警惕原发性肝癌的存在。
Objective To study the diagnostic value of the combination of serum glutamyl transferase (GGT) level and GGT / ALT, AST / ALT ratio in the diagnosis of AFP negative primary liver cancer. Methods Ninety-nine patients with AFP-negative primary hepatocellular carcinoma (HCC) treated in hospital for infection were selected as study group (A), 97 patients with AFP-negative post-hepatitis B cirrhosis (Group B) and 189 Cases (group C) as a control group were studied, and each group of patients with GGT levels and GGT / ALT, AST / ALT ratio comparative analysis. Results The GGT levels in group A, group B and group C were (109.59 ± 111.06) U / L, (51.99 ± 55.00) U / L and (86.76 ± 69.27) U / L, respectively There was statistical significance (P <0.01). The AST / ALT ratios were 1.55 ± 1.02, 1.07 ± 0.56 and 0.51 ± 0.29, respectively. There was a significant difference between group A and the other two groups (P <0.01). The GGT / ALT ratios were 3.43 ± 3.12, 0.78 ± 0.30 and 0.46 ± 0.79, respectively. There was a significant difference between group A and the other two groups (P <0.01). Conclusions In patients with chronic hepatitis B and hepatitis B and liver cirrhosis, liver function tests should be highly vigilant against the presence of primary liver cancer if GGT is elevated and GGT> ALT, AST> ALT, even if AFP is negative.