血清白蛋白、胆碱酯酶及凝血酶原活动度 对病毒性肝炎肝硬化的诊断价值

目的探讨血清白蛋白（ALB）、胆碱酯酶（CHE）、凝血酶原活动度（PTA）检测在病毒性肝炎肝硬化诊断中的价值。方法选取病毒性肝炎肝硬化病人63例（肝硬化组），病毒性肝炎病人60例（肝炎组），同时选取健康体检者60名作为对照组，检测各组ALB、CHE、PTA水平。结果肝硬化组ALB、CHE和PTA明显低于肝炎组和对照组（P < 0.01）；肝硬化组Child-pugh C级病人ALB、CHE和PTA明显低于Child-pugh B级和Child-pugh A级病人（P < 0.05~P < 0.01）；ALB、CHE和PTA诊断病毒性肝炎肝硬化的ROC曲线下面积分别为0.835、0.897和0.746，截断值分别为31.41 g/L、3 785.41 U/L和36.59%时，灵敏度分别为73.30%、85.00%和93.30%，特异度分别为81.00%、79.40%和44.44%。结论病毒性肝炎肝硬化病人ALB、CHE、PTA水平明显降低，可反映病人Child-pugh分级情况，同时具有一定的诊断价值。

Value of the serum albumin,cholinesterase and prothrombin activity in the diagnosis of viral hepatitis cirrhosis

ObjectiveTo investigate the value of serum albumin (ALB), cholinesterase (CHE) and prothrombin activity (PTA) in the diagnosis of viral hepatitis cirrhosis.MethodsSixty-three viral hepatitis cirrhosis patients, 60 viral hepatitis patients and 60 healthy volunteers were divided into the cirrhosis group, hepatitis group and control group, respectively.The levels of ALB, CHE and PTA were detected in three groups.ResultsThe levels of ALB, CHE and PTA in cirrhosis group were significantly lower than those in hepatitis group and control group (P < 0.01).The levels of ALB, CHE and PTA in Child-pugh C patients were significantly lower than those in Child-pugh B and A in cirrhosis group (P < 0.05 to P < 0.01).The areas under the ROC curve of ALB, CHE and PTA in diagnosing viral hepatitis cirrhosis were 0.835, 0.897 and 0.746, respectively; the cut-off values of those were 31.41g/L, 3 785.41 U/L and 36.59%, respectively; the sensitivity of those were 73.30%, 85.00% and 93.30%, respectively, and the specificities of whose were 81.00%, 79.40% and 44.44%, respectively.ConclusionsThe levels of ALB, CHE and PTA in patients with viral hepatitis cirrhosis significantly decrease, which can reflect the classification of Child-pugh, and has certain diagnostic value.