摘要
目的:探讨血清腺苷脱氨酶联合肝纤四项诊断酒精性肝纤维化的应用价值.方法:选取2019年1月-2023年6月在本院接受治疗的169例酒精性肝纤维化患者为研究对象,根据肝纤维化分期,分为Ⅰ期组(n=43)、Ⅱ期组(n=45)、Ⅲ期组(n=42)和Ⅳ期组(n=39),同时选取40例健康者为对照组.对五组腺苷脱氨酶(ADA)、Ⅲ型前胶原(PC-Ⅲ)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)、透明质酸酶(HA)水平进行检测与比较,分析酒精性肝纤维化患者血清ADA水平与PCⅢ、Ⅳ-C、LN、HA水平相关性,同时以病理检查结果为"金标准",观察联合检测与单一检测阳性检出率.结果:ADA、PC-Ⅲ、Ⅳ-C、LN、HA水平对照组均低于Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期组(P＜0.05),且Ⅰ期组均低于Ⅱ期、Ⅲ期、Ⅳ期组(P＜0.05),Ⅱ期组均低于Ⅲ期、Ⅳ期组(P＜0.05),Ⅲ期组低于Ⅳ期组(P＜0.05);血清ADA水平与PC-Ⅲ、Ⅳ-C、LN、HA水平呈正相关(r＞0,P＜0.05);联合检测 ADA、PC-Ⅲ、Ⅳ-C、LN、HA 阳性率均高于单一检测(P＜0.05).结论:ADA、PC-Ⅲ、LN、Ⅳ-C、HA与肝纤维化分期呈正相关,可作为早期诊断酒精性肝纤维化的指标,联合检测更有利于早期临床诊断,有一定的临床应用价值.
Abstract
Objective:To explore the value of combined detection of serum adenosine deaminase and four items of serum liver fibrosis on diagnostic the alcoholic liver fibrosis.Methods:A total of 169 patients with alcoholic liver fibrosis who were treated in our hospital from January 2019 to June 2019 were 2023,according to the stage of liver fibrosis,they were divided into four groups:stage Ⅰ(n=43),stage Ⅱ(n=45),stage Ⅲ(n=42)and stage Ⅳ(n=39).At the same time,40 healthy subjects were selected as control group.The levels of ADA,PC-Ⅲ,Ⅳ-C,LN and HA were measured and compared,and analyze the correlation between serum ADA level and PCⅢ,Ⅳ-C,LN,HA levels in patients with alcoholic liver fibrosis.At the same time,the positive rate of combined test and single test was observed according to the"Gold standard"of pathological examination.Results:The levels of ADA,PC-Ⅲ,Ⅳ-C,LN and HA in the control group were lower than those in the groups of Ⅰ,Ⅱ,Ⅲ and Ⅳ(P＜0.05)and those in the groups of Ⅰ were lower than those in the groups of Ⅱ,Ⅲ and Ⅳ(P＜0.05)and Ⅱ group was lower than Ⅲ group and Ⅳ group(P＜0.05)and Ⅲ group was lower than Ⅳ Group(P＜0.05);Serum ADA levels were positively correlated with PC-Ⅲ,Ⅳ-C,LN and HA(r＞0,P＜0.05);The positive rates were higher of ADA,PC-Ⅲ,Ⅳ-C,LN and HA by combined detection than that by single detection(P＜0.05).Conclusion:ADA,PC-Ⅲ,Ⅳ-C,LN,HA can be used as early diagnostic Indicators of alcoholic liver fibrosis,and their levels are positively correlated with the stage ofliver fibrosis;The combined detection of five items is more beneficial to the early clinical diagnosis,and has certain clinical application value.
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