摘要
目的:分析血清成纤维细胞生长因子21(FGF21)、生长分化因子15(GDF15)与常规肝功能指标联合检测对肝病的诊断价值。方法:选取2020年7月至2022年10月接受治疗的540例肝病患者作为观察组,同期535例健康体检者作为对照组。根据肝脏疾病类型将患者分为急性肝炎组208例、慢性活动性肝炎组140例、慢性迁延性肝炎组104例、肝硬化组56例、肝癌组32例。采用酶联免疫吸附(ELISA)法对患者血清中FGF21、GDF15、总胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、胆碱酯酶(CHE)水平进行测定。分析血清中FGF21、GDF15与常规肝功能指标(TBA、ALT、AST、GGT、CHE)联合诊断肝病的价值。结果:与对照组相比,观察组患者血清FGF21、GDF15、TBA、ALT、AST、GGT水平明显升高(P<0.05),CHE水平显著降低(P<0.05);急性肝炎组、慢性活动性肝炎组、慢性迁延性肝炎组、肝硬化组、肝癌组患者血清FGF21、GDF15、TBA、ALT、AST、GGT、CHE水平差异具有统计学意义(P<0.05)。FGF21、GDF15、TBA、ALT、AST、GGT、CHE对肝病诊断的阳性率分别为78.52%、82.96%、82.96%、80.74%、81.48%、62.22%、57.78%,联合诊断肝病的阳性率为94.26%。FGF21、GDF15在不同肝病的阳性结果差异具有统计学意义(P<0.05),FGF21在几种肝病的阳性率从高到低依次为急性肝炎组、肝癌组、肝硬化组、慢性活动性肝炎组、慢性迁延性肝炎组,GDF15在几种肝病的阳性率从高到低依次为急性肝炎组、肝硬化组、慢性活动性肝炎组、肝癌组、慢性迁延性肝炎组。TBA、ALT、AST、GGT、CHE对不同肝病的阳性结果差异具有统计学意义(P<0.05),FGF21、GDF15与常规肝功能指标联合诊断不同肝病的阳性率均在75%以上。结论:肝病患者血清中FGF21、GDF15、TBA、ALT、AST、GGT水平升高,CHE水平降低,与患者肝病类型有关,多项指标联合检测对肝病具有较好的诊断价值。
Objective:To analyze the diagnostic value of combined detection of serum fibroblast growth factor 21(FGF21),growth differentiation factor 15(GDF15)and routine liver function indexes in liver diseases.Methods:A total of 540 patients with liver disease who were treated in our hospital from July 2020 to October 2022 were selected as the observation group,while 530 healthy controls were selected as the control group.According to the type of liver disease,the patients were divided into acute hepatitis group(n=208),chronic active hepatitis group(n=140),chronic persistent hepatitis group(n=104),cirrhosis group(n=56),and liver cancer group(n=32).The levels of FGF21,GDF15,total bile acid(TBA),alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyltransferase(GGT)and cholinesterase(CHE)in serum were determined by enzyme-linked immunosorbent assay(ELISA).The value of FGF21,GDF15 in serum combined with routine liver function indexes(TBA,ALT,AST,GGT,CHE)in the diagnosis of liver disease was analyzed.Results:Compared with the control group,the levels of serum FGF21,GDF15,TBA,ALT,AST,and GGT in the observation group were obviously higher(P<0.05),while the level of CHE was obviously lower(P<0.05).There were statistically significant differences in serum FGF21,GDF15,TBA,ALT,AST,GGT and CHE levels among active hepatitis group,chronic persistent hepatitis group,liver cirrhosis group and liver cancer group(P<0.05).The positive rates of FGF21,GDF15,TBA,ALT,AST,GGT,and CHE in the diagnosis of liver disease were 78.52%,82.96%,82.96%,80.74%,81.48%,62.22%,and 57.78%,respectively,and the positive rate of combined diagnosis of liver disease was 94.26%The positive results of FGF21 and GDF15 in different liver diseases were obviously different,and the data were statistically significant(P<0.05),the positive rates of FGF21 in several liver diseases from high to low were in acute hepatitis group,liver cancer group,liver cirrhosis group,chronic active hepatitis group and chronic persistent hepatitis group,the positive rates of GDF15 in several liver diseases from high to low were in acute hepatitis group,liver cirrhosis group,chronic active hepatitis group,liver cancer group and chronic persistent hepatitis group.The positive results of routine liver function indexes(TBA,ALT,AST,GGT,CHE)for different liver diseases were obviously different,and the data were statistically significant(P<0.05).The positive rate of combined diagnosis of FGF21,GDF15 and routine liver function indexes for different liver diseases was above 75%.Conclusion:The levels of FGF21,GDF15,TBA,ALT,AST,and GGT in serum of patients with liver disease increase,while the level of CHE decrease,which is related to the type of liver disease.The combined detection of multiple indicators has a good diagnostic value for liver disease.
作者
郭磊
张帅
李晓蕾
GUO Lei;ZHANG Shuai;LI Xiao-lei(Henan Children′s Hospital Zhengzhou Children′s Hospital Laboratory Department(Zhengzhou Henan,450000),China.)
出处
《中西医结合肝病杂志》
CAS
2023年第8期688-691,697,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
河南省医学科技攻关计划联合共建项目(No.LHGJ20190971)。
