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目的了解慢性HBV携带者血清中肝功能相关蛋白胆碱脂酶(Ch E)、白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(TRF)、铁蛋白(FRT)、C反应蛋白(CRP)、铜蓝蛋白(CER)的水平,并且探讨这些蛋白对慢性HBV携带者的诊断价值。方法选取2012年1月至2014年7月在重庆医科大学附属永川医院就诊的86例慢性HBV携带者作为观察组,另外选取102例健康体检者作为对照组,分别检测其血清中Ch E、Alb、PA、TRF、FRT、CRP、CER等生化指标,并对部分观察组人群进行肝穿刺活组织检查。计量资料组间比较采用独立样本t检验。结果观察组与对照组的CER水平分别为(0.20±0.04)g/L、(0.29±0.06)g/L,差异有统计学意义(t=2.03,P=0.03),其他指标差异均无统计学意义(P值均>0.05);观察组中,肝脏炎症程度高或纤维化程度高的患者血清中CER水平下降明显,差异均有统计学意义[(0.23±0.01)g/L vs(0.18±0.02)g/L,t=-2.6,P=0.01;(0.22±0.02)g/L vs(0.17±0.04)g/L,t=-3.2,P=0.004)。结论血清中CER水平的变化能反映早期肝脏炎症和纤维化程度,并可能成为慢性HBV携带者早期诊断与治疗的重要指标。
Objective To investigate the relationship between serum levels of ChE, Alb, PA, TRF, FRT, C-reactive protein (CRP) and ceruloplasmin (ceruloplasmin), and to investigate the diagnostic value of these proteins in chronic HBV carriers. Methods Totally 86 chronic HBV carriers attending Yongchuan Hospital Affiliated to Chongqing Medical University from January 2012 to July 2014 were selected as the observation group. Another 102 healthy volunteers were selected as the control group, and their serum levels of ChE, Alb , PA, TRF, FRT, CRP, CER and other biochemical indicators, and some of the observation group of liver biopsy. Measurement data were compared between groups using an independent sample t test. Results The levels of CER in observation group and control group were (0.20 ± 0.04) g / L and (0.29 ± 0.06) g / L respectively, with statistical significance (t = 2.03, P = 0.03) (P <0.05). In the observation group, the level of CER in serum of patients with high degree of liver inflammation or fibrosis decreased significantly ([0.23 ± 0.01] g / L vs 0.18 ± 0.02) g / L, t = -2.6, P = 0.01; (0.22 ± 0.02) g / L vs (0.17 ± 0.04) g / L, t = -3.2, P = 0.004). Conclusion The change of serum CER level can reflect the degree of early liver inflammation and fibrosis, and may be an important index for the early diagnosis and treatment of chronic HBV carriers.