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目的:探讨肝脏传统实验室指标〔丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)、平均红细胞体积(MCV)〕和糖缺失性转铁蛋白亚型二唾液酸百分含量(%DST)在酒精性肝病(ALD)中的诊断价值。方法:将我院2014年6月—2015年6月收治的30例明确诊断为ALD和30例非酒精性肝病(NAFLD)及30例体检健康者血清ALT、AST、GGT、MCV和%DST水平,分别分析检测诊断ALD的受试者工作曲线下面积(ROC-AUC)、敏感度和特异性。结果:ALD组血清%DST和GGT曲线下面积,敏感度和特异性均高于NAFLD组和健康对照组(%DSTAUC=0.940、敏感度90.0%、特异性90.3%、P<0.001;GGTAUC=0.766、敏感度76.7%、特异性77.4%、P<0.001;ALTAUC=0.502、敏感度50.0%、特异性61.3%、P<0.001;ASTAUC=0.345、敏感度33.3%、特异性71.0%,P=0.433;MCVAUC=0.546、敏感度43.3%、特异性77.4%,P=1.000)。%DST和GGT对ALD有显著性差异(均P<0.001),%DST诊断ALD的敏感度高于GGT,%DST和GGT联合检测诊断ALD的敏感度(96.7%)高于单项检测。结论:血清%DST和GGT对诊断ALD具有较高的临床价值,%DST诊断ALD的敏感度明显高于GGT,尤其是相对于其他肝脏酶类标志物,%DST在肝脏疾病存在时对于酒精摄入表现出更好的特异性和抗干扰能力,两者联合检测可提高单独检测的敏感度。
OBJECTIVE: To investigate the correlation between liver laboratory indexes (ALT, AST, GGT and MCV) and Diagnostic value of the percentage of disulphuric transferrin subunit disialoic acid (% DST) in alcoholic liver disease (ALD). Methods: The serum levels of ALT, AST, GGT, MCV and% DST in 30 patients diagnosed as ALD, 30 non-alcoholic liver disease (NAFLD) and 30 healthy controls were analyzed from June 2014 to June 2015 in our hospital. (ROC-AUC), sensitivity and specificity of subjects undergoing diagnostic ALD were analyzed respectively. Results: The area, sensitivity and specificity of serum% DST and GGT curves in ALD group were higher than those in NAFLD group and healthy control group (% DST AUC = 0.940, 90.0% sensitivity and 90.3% specificity, P <0.001) AUC = 0.766, sensitivity 76.7%, specificity 77.4%, P <0.001; ALT AUC = 0.502, sensitivity 50.0%, specificity 61.3%, P <0.001; AST AUC = 0.345, sensitivity 33.3% Specificity 71.0%, P = 0.433; MCV AUC = 0.546, sensitivity 43.3%, specificity 77.4%, P = 1.000). % DST and GGT had significant differences (all P <0.001). The sensitivity of% DST in diagnosis of ALD was higher than that of GGT. The sensitivity of combined detection of% DST and GGT was 96.7% higher than that of single detection. Conclusions: Serum% DST and GGT have high clinical value in the diagnosis of ALD. The sensitivity of% DST in diagnosing ALD is significantly higher than that of GGT, especially in relation to other liver enzyme markers, and% DST in the presence of liver disease Into the show better specificity and anti-interference ability, combined detection of the two can improve the sensitivity of individual tests.