血清GGT与ALP联合检测对无症状继发性胆总管结石诊断价值的临床研究

目的探讨GGT与ALP联合检测对无症状继发性胆总管结石诊断的临床价值。方法收集1 060例胆道结石病患者的临床资料,根据是否合并无症状继发性胆总管结石,分为观察组和对照组。计数资料采用X²检验;计量资料采用独立样本t检验,并采用ROC曲线求取最佳诊断界值所对应的灵敏度、特异度等诊断学指标。比较两组肝功能指标(ALT、AST、GGT、ALP、TBil、DBil),评价各指标的临床意义。结果观察组患者血清GGT(159.72±40.28)、ALP(176.45±43.17)含量明显高于对照组GGT(36.07±10.38)和ALP(137.98±38.19)水平(P<0.05)。ROC曲线分析结果显示:GGT、ALP、GGT+ALP的曲线下面积分别为0.909、0.670、0.927,灵敏度分别为92.6%、68.2%、94.1%,特异度分别为86.9%、60.1%、87.5%;GGT、ALP临界值分别为98.5U/L、152.5U/L。两组患者血清AST、ALT、TBil及DBil的比较无统计学差异(P>0.05)。结论血清GGT及ALP的联合检测对无症...

Diagnostic value of combined detection of serum GGT and ALP in asymptomatic secondary common bile duct stones

Objective To investigate the diagnostic value of combined detection of serum GGT and ALP in asymptomatic secondary common bile duct stones. Methods The clinical data of 1060 patients with biliary calculi were collected and divided into observation group and control group according to whether they were complicated with asymptomatic secondary common bile duct stones. The counting data were tested by X2 test, and the measurement data were analyzed by t test. The ROC curve was used to determine the sensitivity and specificity of the best diagnostic value. The liver function indexes, including ALT, AST, GGT, ALP, TBil and DBil, were compared between the two groups. Results The serum levels of GGT(159.72SymbolqB@40.28 U/L) and ALP(176.45SymbolqB@43.17 U/L) in the observation group were significantly higher than those in the control group with GGT(36.07SymbolqB@10.38 U/L) and ALP(137.98SymbolqB@38.19 U/L)(P<0.05). The results of ROC curve analysis showed that the areas under the curve of GGT, ALP and GGT+ALP were 0.909, 0.670 and 0.927, the sensitivity were 92.6%, 68.2% and 94.1%, the specificity were 86.9%, 60.1% and 87.5%, and the critical values of GGT and ALP were 98.5 U/L and 152.5 U/L, respectively. There was no significant difference in serum AST, ALT, TBil and DBil between the two groups(P>0.05). Conclusion The combined detection of serum GGT and ALP has important clinical value in early prediction of asymptomatic secondary choledocholithiasis. It is convenient, fast and cheap examination, and is worthy of clinical application and promotion.