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Received:April 15, 2021 Published Online:November 20, 2021
Received:April 15, 2021 Published Online:November 20, 2021
中文摘要: 目的 探讨胰岛素样生长因子1(IGF-1)、视黄醇结合蛋白(RBP)和胆碱酯酶(CHE)在肝硬化诊断中的临床意义。方法 回顾性分析2018年10月至2020年10月就诊于延安大学附属医院消化内科111例病毒性肝炎肝硬化患者(肝硬化组)的临床资料。另选择同期住院病毒性肝炎不伴肝硬化患者34例为肝炎组;对照组为同期健康体检者55例。所有患者入院后均通过化学发光法测定IGF-1值,全自动生化分析仪常规方法测定RBP和CHE值。比较三组IGF-1、RBP、CHE水平及其对肝硬化的诊断效能。结果 肝硬化组IGF-1、RBP、CHE值低于肝炎组和对照组,差异有统计学意义(P<0.05)。血清IGF-1、CHE、RBP水平随着Child-Pugh分级的增加而降低,在Child-Pugh A级组与B、C级组差异有统计学意义(P<0.01),B级组和C级组间差异无统计学意义(P>0.05)。RBP和CHE的阳性率随着Child-Pugh评分分级的增加逐渐增高(P<0.01)。IGF-1、RBP和CHE值均与Child-Pugh分级呈负相关(r=-0.297、-0.396、-0.609,P<0.01)。血清IGF-1、CHE、RBP水平预测病毒性肝硬化的ROC曲线下面积(AUC)分别为0.947、0.915、0.838,最佳临界值分别为96.9 ng/ml,4 707.0 u/L,19.8 mg/L,三指标联合检测AUC为0.979,高于单独指标。结论 IGF-1、RBP和CHE能很好的反应肝脏功能的情况,且三个指标存在明显相关性,在预测肝硬化的诊断上有一定的临床意义。
Abstract:Objective To investigate the clinical significance of insulin-like growth factor 1 (IGF-1), retinol binding protein (RBP) and cholinesterase (CHE) in the diagnosis of liver cirrhosis. Methods A retrospective analysis was performed on the clinical data of 111 patients with viral hepatitis related liver cirrhosis admitted to Yanan University Affiliated Hospital of from October 2018 to October 2020(cirrhosis group). In the same period, 34 patients of viral hepatitis without cirrhosis were selected as hepatitis group, and 55 healthy subjects were served as control group. IGF-1 was measured by chemiluminescence, RBP and CHE were determined by automatic biochemical analyzer. The levels of IGF-1, RBP and CHE were compared among three groups to analyze their diagnostic efficacy in liver cirrhosis. Results The levels of IGF-1, RBP and CHE in cirrhosis group were significantly lower than those in hepatitis group and control group (P<0.05), and decreased with the increase of Child-Pugh grades, there was a significant difference between Child-Pugh grade A and Child-Pugh grade B and C (P<0.01), and there ws no statistically significant difference between Child-Pugh grade B group and C group (P>0.05). The positive rates of RBP and CHE increased statistically with the increase of Child-Pugh grade (P<0.01). IGF-1, RBP and CHE levels were negatively correlated with Child-Pugh grading (r=-0.297, -0.396, -0.609, P<0.01). The area under ROC of IGF-1, CHE, and RBP was 0.947, 0.915, 0.838, respectively, and the cut-off points were 96.9 ng/ml, 4 707.0 u/L and 19.8 mg/L, respectively. AUC of combined detection of IGF-1, RBP and CHE was respectively higher than those of single indicator. Conclusion IGF-1, RBP and CHE can well evaluate the liver function of liver cirrhosis, and there is a significant correlation among the three indicators, which has a certain clinical significance in predicting liver cirrhosis.
文章编号: 中图分类号:R575.2 文献标志码:A
基金项目:陕西省卫生健康科研基金项目(2018C010);延安市科学技术研究发展计划项目(2018KS-29)
Author Name | Affiliation |
DUAN Xiao-xia, XUE Shun-he, LIU Qian, LIU Jie, ZHAO Yu, HAN Wen | Department of Gastroenterology, Yanan University Affiliated Hospital, Yanan, Shaanxi 716000, China |
Author Name | Affiliation |
DUAN Xiao-xia, XUE Shun-he, LIU Qian, LIU Jie, ZHAO Yu, HAN Wen | Department of Gastroenterology, Yanan University Affiliated Hospital, Yanan, Shaanxi 716000, China |
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