肝脏硬度值及血清CER、AST水平在ALT轻度升高乙肝患者肝纤维化中的评估价值

doi:10.3969/j.issn.1671-7171.2024.05.007

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摘要【目的】探讨肝脏硬度值(LSM)及血清铜蓝蛋白(CER)、谷草转氨酶(AST)在丙氨酸转氨酶(ALT)轻度升高乙肝患者肝纤维化中的评估价值。【方法】选取2020年6月至2022年6月本院收治的100例ATL轻度升高的乙肝患者,根据肝纤维化分期情况将其分为无纤维化组(n=10)和纤维化组(n=90)。根据肝纤维化严重程度情况将患者分为重度纤维化组(n=42)、中度纤维化组(n=36)、轻度纤维化组(n=12)。比较不同组别患者ALT、白蛋白(ALB)、AST及CER、LSM,绘制受试者工作特征(ROC)曲线分析CER、AST、LSM对ALT轻度升高乙肝患者肝纤维化的评估价值。【结果】两组患者ALT、ALB比较,差异无统计学意义(P>0.05);纤维化组AST、LSM均高于无纤维化组,CER低于无纤维化组,差异有统计学意义(P<0.05)。ROC曲线分析显示,AST、CER、LSM评估ATL轻度升高乙肝患者肝纤维化的曲线下面积分别为0.914、0.616、0.946(P<0.05)。重度纤维化组、中度纤维化组、轻度纤维化组CER逐渐升高,差异有统计学意义(P<0.05);重度纤维化组、中度纤维化组、轻度纤维化组AST、LSM逐渐降低,差异有统计学意义(P<0.05)。【结论】不同纤维化程度的ATL轻度升高乙肝患者AST、CER、LSM存在差异,其中AST、CER、LSM对于肝纤维化有一定评估价值,可用于临床对此类患者肝纤维化的早期诊断或评估。

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	杜香山

关键词 ：肝纤维化, 乙型肝炎, 血浆铜蓝蛋白, 天冬氨酸氨基转移酶类, 丙氨酸转氨酶

Abstract：【Objective】To explore the value of ultrasound in detecting liver stiffness (LSM), serum ceruloplasmin (CER) and aspartate aminotransaminase (AST) in evaluating liver fibrosis of patients with mild elevation of alanine aminotransferase (ALT).【Methods】From June 2020 to June 2022, 100 patients with hepatitis B showing slightly elevated ATL admitted to our hospital were divided into non-fibrosis group (n=10) and fibrosis group (n=90) according to the stage of liver fibrosis. According to the severity of liver fibrosis, patients were divided into severe fibrosis group (n=42), moderate fibrosis group (n=36), and mild fibrosis group (n=12). The value of ALT, albumin (ALB), AST and CER, LSM was compared in different groups of patients. The ROC curve of subjects was drawn to analyze the evaluation value of CER, AST, LSM on liver fibrosis in hepatitis B patients with mild elevation of ALT.【Results】There was no statistically significant difference in ALT and ALB between the two groups of fibrosis and non-fibrosis patients (P>0.05); The AST and LSM of the fibrosis group were higher than those of the non-fibrosis group, and the CER of the fibrosis group was lower than that of the non-fibrosis group, with statistical significance (P<0.05). ROC curve analysis showed that the area under the curve of AST, CER and LSM for evaluating liver fibrosis in hepatitis B patients with slightly elevated ATL was 0.914, 0.616 and 0.946, respectively (P<0.05). The CER of the severe fibrosis group, the moderate fibrosis group, and the mild fibrosis group gradually increased, and the difference was statistically significant (P<0.05); The AST and LSM gradually decreased in the severe fibrosis group, moderate fibrosis group, and mild fibrosis group, and the difference was statistically significant (P<0.05).【Conclusion】There are differences in AST, CER and LSM in patients with hepatitis B with slightly elevated ATL at different levels of fibrosis. AST, CER and LSM have certain evaluation value for liver fibrosis and can be used for early diagnosis or evaluation of liver fibrosis in such patients.

Key words： Hepatic Fibrosis Hepatitis B Ceruloplasmin Aspartate Aminotransferases Alanine Transaminase

收稿日期: 2022-01-21

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R575.2

引用本文:

杜香山. 肝脏硬度值及血清CER、AST水平在ALT轻度升高乙肝患者肝纤维化中的评估价值[J]. 医学临床研究, 2024, 41(5): 666-668.
DU Xiangshan. Application of Liver Stiffness, Serum CER and AST Levels in Evaluating Liver Fibrosis of Patients with ALT Elevated Hepatitis B. JOURNAL OF CLINICAL RESEARCH, 2024, 41(5): 666-668.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.05.007 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I5/666

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