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目的分析传统实验室检测指标对酒精性肝病(alcoholic liver disease,ALD)的诊断价值。方法男性肝病患者63例,其中非酒精性肝病(non-alcoholic liver disease,NALD)35例(NALD组),ALD患者28例(ALD组);同期体检健康者28例为对照组。比较3组患者血清γ-谷氨酰转移酶(gamma-glutamyl transferase,GGT)、纤维结合蛋白(fibronectin,Fn)、谷草转氨酶(glutamic-oxaloacetic transaminase,GOT)水平,观察ALD组治疗前、后3项指标的变化,评估Fn、GGT及GOT对ALD的诊断价值。结果治疗前ALD组和NALD组患者血清GGT[(67.5±54.4)、(69.8±49.6)u/L)]、Fn[(335.6±59.5)、(354.0±62.1)mg/L]及GOT[(19.3±10.3)、(10.4±7.3)u/L)]均高于对照组[(18.5±8.3)u/L、(207.4±21.3)mg/L、(7.0±4.5)u/L)](P<0.05),ALD组血清GOT水平高于NALD组(P<0.05);治疗后ALD组血清Fn[(277.0±71.3)mg/L]和GOT[(7.4±5.3)u/L]较治疗前下降(P<0.05),GGT[(62.7±53.6)u/L]与治疗前比较差异无统计学意义(P>0.05);ALD组GOT阳性率(75.0%)高于NALD组(45.7%)(P<0.05),Fn、GGT阳性率(57.1%、89.3%)与NALD组(60.0%、88.6%)比较差异无统计学意义(P>0.05)。结论 GGT、GOT及Fn可用于ALD患者的诊断和鉴别诊断,GGT诊断ALD的敏感性高,GOT和Fn对评价ALD患者药物疗效有一定价值。
Objective To analyze the diagnostic value of traditional laboratory tests on alcoholic liver disease (ALD). Methods Sixty-three male patients with liver disease were enrolled, including 35 with non-alcoholic liver disease (NALD) and 28 with ALD (ALD). 28 healthy controls were included in the study. The levels of GGT, Fn and GOT in the three groups were compared before and after treatment with ALD, and the serum levels of GGT, fibronectin (Fn) and glutamic-oxaloacetic transaminase (GOT) Item index changes to assess the diagnostic value of Fn, GGT and GOT on ALD. Results The serum levels of GGT [(67.5 ± 54.4) and (69.8 ± 49.6) u / L), Fn [(335.6 ± 59.5) and (354.0 ± 62.1) mg / L] and GOT [ 19.3 ± 10.3) and (10.4 ± 7.3) u / L, respectively, were significantly higher than those in the control group (18.5 ± 8.3 u / L, 207.4 ± 21.3 mg / L and 7.0 ± 4.5 u / L, respectively) (277 ± 71.3) mg / L] and GOT [(7.4 ± 5.3) u / L] in ALD group were significantly higher than those in NALD group (P <0.05) (P <0.05). There was no significant difference in GGT [(62.7 ± 53.6) u / L] before treatment (P> 0.05). The positive rate of GOT in ALD group was higher than that in NALD group (45.7% (P <0.05). There was no significant difference in the positive rate of Fn and GGT between the two groups (57.1%, 89.3%) and the NALD group (60.0% and 88.6%, P> 0.05). Conclusion GGT, GOT and Fn can be used in the diagnosis and differential diagnosis of patients with ALD. The sensitivity of GGT in diagnosis of ALD is high. GOT and Fn are valuable in evaluating the therapeutic effect of ALD.