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[目的]通过对乙型病毒性肝炎肝硬化(HBC)患者的生化指标ALB、GLB及A/G的表达情况进行分析,探讨其在HBC病情评估中的临床价值,为将来的临床诊治提供理论依据。[方法]选取2015年2月~2016年12月我院收治的非HBC慢性乙型病毒性肝炎及HBC患者作为研究对象,回顾分析符合条件的病例患者有无肝性脑病及腹水、胆红素、ALB、GLB、A/G、PT情况等资料,对HBC患者进行Child-Pugh评分与分级。[结果]HBC患者根据Child-Pugh评分进行分级:A级13例,B级14例,C级10例。肝硬化组随着Child-Pugh分级的提高,其血清ALB浓度、A/G值均逐步降低,而GLB浓度逐步升高,差异均有统计学意义(P<0.05)。HBC患者血清ALB浓度与Child-Pugh评分分级呈负相关(r=-0.932,P<0.01);GLB浓度与Child-Pugh评分分级呈正相关(r=0.949,P<0.01);A/G比值与Child-Pugh评分分级呈负相关(r=-0.945,P<0.01)。HBC评价参数中血清ALB的敏感度、特异度、约登指数分别为0.798、0.603、0.401;血清GLB的敏感度、特异度、约登指数分别为0.663、0.711、0.374;A/G比值的敏感度、特异度、约登指数分别为0.559、0.823、0.382。[结论]ALB、GLB、A/G比值对肝硬化代偿期的诊断具有重要的参考意义,可以对代偿期的肝硬化做出合理诊断,且具有很强的操作性和可行性。
[Objective] To investigate the clinical value of biochemical markers ALB, GLB and A / G in patients with hepatitis B cirrhosis (HBC) and evaluate their clinical value in the evaluation of HBC and provide theory for future clinical diagnosis and treatment in accordance with. [Methods] From February 2015 to December 2016 in our hospital admitted to non-HBC patients with chronic hepatitis B and HBC patients as the research object, retrospective analysis of eligible patients with or without hepatic encephalopathy and ascites, bilirubin , ALB, GLB, A / G, PT and other data, Child-Pugh score and grading of HBC patients. [Results] The HBC patients were graded according to Child-Pugh score: 13 cases of A grade, 14 cases of B grade and 10 cases of C grade. With the increase of Child-Pugh classification, the levels of ALB and A / G in serum of patients with cirrhosis gradually decreased, while the concentrations of GLB gradually increased, with statistical significance (P <0.05). The serum ALB level of HBC patients was negatively correlated with Child-Pugh score (r = -0.932, P <0.01). The GLB concentration was positively correlated with Child-Pugh score (r = 0.949, P <0.01) Child-Pugh score was negatively correlated (r = -0.945, P <0.01). The sensitivity, specificity and Youden index of serum ALB in HBC evaluation parameters were 0.798, 0.603 and 0.401 respectively. The sensitivity, specificity and Youden index of serum GLB were 0.663, 0.71 1 and 0.374, respectively; the sensitivity of A / G ratio Degree, specificity, Youden index were 0.559,0.823,0.382. [Conclusion] The ALB, GLB and A / G ratios have important reference value for the diagnosis of decompensated liver cirrhosis. They can make a reasonable diagnosis of decompensated cirrhosis and have good operability and feasibility.