【摘要】 目的应用逐步判别分析方法,评价肝功能、肝纤维化、细胞因子或受体检测在急性乙型病毒性肝炎(急性肝炎)、慢性乙型病毒性肝炎(慢性肝炎)和乙型病毒性肝硬化(肝硬化)诊断中的作用。方法乙型病毒性肝炎患者(乙肝组)74例,对照组22例,应用生化自动分析仪检测血清总胆红素(TB)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、凝血酶原活动度(PTA)和血清胆碱酯酶(ChE);放射免疫法检测层黏蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(CⅣ)、Ⅲ型前胶原(PⅢP);ELISA方法检测可溶性白细胞介素-2受体(sIL-2R)、转化生长因子-β1(TGF-β1)、可溶性细胞间黏附分子-1(sICAM-1)。各组样本比较用秩和检验;建立判别方程用逐步判别分析。结果急、慢性肝炎和肝硬化患者血清TB、ALT、AST、sIL-2R、TGF-β1、sICAM-1水平比对照组显著升高(P<0.01);中、重度慢性肝炎或肝硬化患者血清PTA、ChE、LN、CⅣ、PⅢP、HA水平与对照组比较差别有统计学意义(P<0.01)。经逐步判别分析建立典型判别函数方程表明:ALT、ChE、sIL-2R、TGF-β1s、ICAM-1是判别正常与乙型肝炎的主要指标;TB、ALT、PTA、LN、CⅣ、HA、TGF-β1是判别急性肝炎、慢性肝炎与肝硬化的主要指标;TB、AST、PTA、PⅢPs、ICAM-1是判别轻、中、重度慢性肝炎的主要指标。结论经逐步判别分析筛选的肝炎血清学检测指标具有区别乙型病毒性急性肝炎、慢性肝炎、肝硬化的作用。更多还原

【Abstract】 Objective To study the diagnostic value of serum markers in the viral hepatitis B and cirrhosis.Methods Serum total bilirubin（TB）,ALT,AST,prothrombin activaty（PTA）,cholinesterase（ChE） were detected by automatic biochemical analyzer;laminin（LN）,collagen type Ⅳ（CⅣ）,procollagen peptide Ⅲ（PⅢP）,hyaluronic（HA） by radioimmunoassay（RIA）;sIL-2R,TGF-β₁,sICAM-1 by ELISA in 22 cases normal control,20 cases with acute hepatitis B（AHB）,35 cases with chronic hepatitis B（CHB）,19 cases with liver cirrhosis（LC）.The serum markers level was statisticsed by rank test and stepwise discrimination analyses.Results Serum TB,ALT,AST,sIL-2R,TGF-β₁,sICAM-1 levels in AHB,CHB and LC were significantly higher than those in normal control（P<0.01）;PTA,ChE,LN,CⅣ,PⅢP, HA level in severe CHB and LC were significantly different with normal control（P<0.01）.To discriminate hepatitis and normal control,ALT,ChE,sIL-2R,TGF-β₁,sICAM-1 were selected to set up a diagnosis.TB,ALT,PTA,LN,CⅣ,HA,TGF-β₁ were selected to discriminate AHB,ChB and LC;TB,AST,PTA,PⅢP,sICAM-1 were selected to discriminate the stage of CHB.Conclusion The serum markers had the value in judging AHB,CHB and LC.更多还原