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2018 年第 6 期 第 13 卷

丙型肝炎病毒RNA载量和肝功能联合检测在丙型肝炎诊断中的意义

Significances of hepatitis C virus RNA and liver function indicators in diagnosis of heptitis C

作者:李娟刘义庆张玥于淼董振芳范刚王长印卢志明张炳昌

英文作者:

单位:250021济南,山东大学附属省立医院临床医学检验部

英文单位:

关键词:丙型肝炎;肝功能指标;丙型肝炎病毒;核糖核酸

英文关键词:

  • 摘要:
  • 【摘要】目的    探讨超敏丙型肝炎病毒(HS-HCV)RNA载量与肝功能指标联合检测在丙型肝炎诊断中的临床意义。方法    选取2016年1月至2017年6月在山东大学附属省立医院确诊为丙型肝炎的患者904例。采用实时荧光定量聚合酶链反应法检测HS-HCV RNA;全自动生化分析仪检测肝功能指标,包括总胆红素、直接胆红素(DBIL)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)和α-L-岩藻糖苷酶(AFU)水平。采用受试者工作特征曲线分析肝功能指标对丙型肝炎的诊断价值。结果    女性患者的HS-HCV RNA阳性率明显高于男性[53.4%(230/431)比43.3%(205/473)](χ2=9.076,P<0.05)。HS-HCV RNA载量不同分组间总胆红素、DBIL、AST、ALT和AFU异常率差异均有统计学意义(均P<0.01)。丙型肝炎患者肝功能指标异常率最高的是AST(40.3%)。肝功能指标单项检测曲线下面积最高的是AST(0.765),联合检测的曲线下面积为0.853;AST诊断丙型肝炎的灵敏度最高(74.8%),ALT诊断丙型肝炎的特异度最高(79.7%),联合检测的灵敏度(77.8%)和特异度(78.0%)均高于单项检测。结论    HS-HCV RNA载量反映了病毒复制和病程的变化,与肝功能检测结果明显相关。HS-HCV RNA载量及肝功能单项检测与联合检测对于丙型肝炎均有诊断价值,可以全面了解患者的病情进展与转归,为患者治疗提供可靠的依据。

  • 【Abstract】Objective    To explore the clinical significances of hypersensitive hepatitis C virus(HS-HCV) RNA and liver function indicators in diagnosis of heptitis C. Methods    Totally 904 patients with hepatitis C were enrolled from January 2016 to June 2017 in Shandong Provincial Hospital Affiliated to Shandong University. HS-HCV RNA was detected by the real-time fluorescent quantitative polymerase chain reaction. Levels of total bilirubin(TBIL), direct bilirubin(DBIL), aspartate aminotransferase(AST), alanine aminotransferase(ALT) and α-L-fucosidase(AFU) were detected by the automatic biochemical analyzer. Values of liver function indicators in diagnosis of heptitis C were analyzed by the receiver operating characteristic(ROC) curve. Results    Positive rate of HS-HCV RNA in female patients was significantly higher than that in male patients[53.4%(230/431) vs 43.3%(205/473)](χ2=9.076, P<0.05). Abnormal rates of TBIL, DBIL, AST, ALT and AFU showed significant differences among groups with different HS-HCV RNA(P<0.01). Abnormal rate of AST was the highest in hepatitis C patients(40.3%). Area under curve of AST in diagnosis of heptitis C was 0.765; area under curve of combined detection of 5 liver function indicators was 0.853. The sensitivity of AST(74.8%) and the specificity of ALT(79.7%) was the highest in diagnosis of heptitis C; combined detection showed higher sensitivity(77.8%) and specificity(78.0%). Conclusions    HS-HCV RNA can reflect virus replication and course of hepatitis C; it is associated the levels of liver function indicators. HS-HCV RNA and liver function indicators have good diagnostic values for hepatitis C.

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