慢性乙肝患者脯氨酸肽酶与肝纤维化的关系分析

目的了解血清脯氨酸肽酶（prolidase,PLD）与乙型病毒性肝炎肝纤维化程度的关系。方法测定191例乙型肝炎患者血清中PLD水平,利用ROC曲线分析ALT、AST、AST/ALT和PLD的面积,判断PLD的最优截断点并计算不同标准的灵敏度、特异度、阳性预测值（PPV）、阴性预测值（NPV）、Youden指数。结果慢性乙型肝炎患者PLD值随着肝纤维化严重程度升高,S2-4期（明显肝纤维化）明显高于S0-1期（无明显肝纤维化）（P〈0.01）。ALT、AST、AST/ALT和PLD的ROC曲线下面积分别为0.614、0.648、0.655和0.807。PLD的最优截断点约为1 250 U/L,灵敏度和特异度分别为75.6%和75.2%。结论血清PLD测定对于慢性乙型肝炎患者肝纤维化程度判定有一定的临床价值。

The relationship between prolidase and liver fibrosis in chronic hepatitis B patients

Objective To study the relationship between prolidase （PLD） and liver fibrosis in chronic hepatitis B patients. Methods PLD activity in serum collected from 191 patients with hepatitis B were determined. Receiver operating characteristic curve （ROC） was used to evaluate diagnostic value of PLD activity. Results PLD values of hepatitis B patients rose with liver fibrosis severity, and PLD value of S2-4 phases was higher than that of S0.1 phases （P 〈0.01 ）. The AUROC of ALT, AST, AST/ALT and PLD were 0. 614, 0. 648, 0. 655 and 0. 807, respectively. The optimal cutoff value of PLD was 1 250 U/L. Sensitivity and specificity were 75.6% and 75.2% , respectively. Conclusion PLD is a potent marker for assessing liver fibrosis stages in chronic hepatitis B patients.