多指标联合检测在肝病诊断中的意义

目的了解谷丙转氨酶（ALT）、谷草转氨酶（AST）、α-岩藻糖苷酶（AFU）、天冬氨酸氨基转移酶同工酶（ASTm）、腺苷脱氨酶（ADA）、亮氨酸氨基肽酶（LAP）6项指标在肝病诊断中的意义,且分析筛选了多指标联合检测用于肝病诊断。方法使用全自动生化分析仪对156例各种肝病和43例正常人血清的6项指标进行检测,用统计软件SPSS 13.0对检测结果进行统计学分析。结果急性肝炎时ALT、ASTm、AST、LAP均显著增高,其AUC分别为0.863、0.897、0.714、0.879;慢性肝炎重度时ALT、AST、ASTm显著升高,其AUC分别为0.875、0.895、0.786;肝硬化时ADA、AST均显著升高,其AUC分别为0.896、0.850;肝癌时ASTm、ADA、LAP、AFU均显著升高,其AUC分别为0.679、0.888、0.723、0.844。结论联合检测ASTm、LAP、AFU、ALT可以很好地诊断急性肝炎;联合ADA、AFU可以很好地诊断肝癌;联合ADA、AST可以很好地诊断肝硬化;联合AST、LAP、ADA和ALT可以很好地诊断慢性肝炎重度。

Diagnostic value of multiple combined detection indexes in liver diseases

Objective To discuss the diagnostic value of the examination of serum ALT,AST,AFU,ASTm,ADA and LAP in the patients suffering from liver diseases,and to screen the multiple combined detection indexes for the diagnosis of liver diseases.Methods Serums of 156 hepatitis cases and 43 healthy cases were examined with auto biochemical analyzer and analyzed statistically with SPSS 13.0.Results The mean values of ALT,ASTm,AST and LAP in acute hepatitis patients were higher than those of healthy cases significantly,AUC of ALT,ASTm,AST and LAP was 0.863,0.897,0.714 and 0.879 separately;the mean values of ALT,AST and ASTm in serious chronic hepatitis patients were higher than those of healthy cases significantly,AUC of ALT,AST and ASTm was 0.875,0.895 and 0.786;the mean values of ADA and AST in liver cirrhosis patients were higher than those of healthy cases significantly,AUC of ADA and AST was 0.896 and 0.850;the mean values of ASTm,ADA,LAP and AFU in liver cancer patients were higher than those of healthy cases significantly,AUC of ASTm,ADA,LAP and AFU was 0.679,(0.888),(0.723) and 0.844.Conclusion Combined measurements of ASTm,LAP,AFU and ALT are more valuable in the diagnosis of acute hepatitis;combined measurements of ADA and AFU are more valuable in the diagnosis of liver cancer;combined measurements of ADA and AST are more valuable in the diagnosis of liver cirrhosis;combined measurements of AST,LAP,ADA and ALT are more valuable in the diagnosis of serious chronic hepatitis.