1. ALT 小于2倍正常值上限的慢性乙型肝炎患者显著肝脏炎症的简易血清标志物探索
- Author
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李 强, 黄玉仙, and 陈 良
- Abstract
Objective To investigate the simple serum markers for significant liver inflammation in chronic hepatitis B (CHB)patients with an alanine aminotransferase (ALT)level of <2 times upper limit of normal (ULN). Methods The clinical data of 278 CHB patients with ALT <2 × ULN (ULN =40 U/ L)were analyzed retrospectively. Significant liver inflammation was defined as a liver inflammatory activity grade (G)≥2. The t - test was used for comparison of normally distributed continuous data between groups,and the Kruskal - Wallis rank sum test was used for non - normally distributed continuous data;the chi - square test was used for comparison of categorical data between groups. Multivariate logistic regression analysis was used to identify independent predictors for significant liver inflammation in CHB patients with ALT <2 × ULN. The receiver operating characteristic (ROC)curve was used to evaluate the diagnostic value of serum markers in significant liver inflammation. Results Of the 278 CHB patients enrolled,175 (62. 9% )had no significant liver inflammation (G0 - 1 group)and 103 (37. 1% )had significant liver inflammation (G2 - 4 group). There were significant differences in ALT,aspartate aminotransferase,alkaline phosphatase,gamma - glutamyl transpeptidase (GGT),albumin,globulin,prothrombin time (PT),platelet,absolute neutrophil count,hyaluronic acid (HA),glycocholic acid,precollagen Ⅲ,and collagen type Ⅳ(ⅣC)between the two groups (all P <0. 05). The multivariate regression analysis showed that GGT,PT,ⅣC,and HA were independent predictors for significant liver inflammation in CHB patients with ALT <2 × ULN (OR =1. 015,1. 600,1. 151,and 1. 014,P =0. 008,0. 021,0. 003,and 0. 018). The areas under the ROC curve for GGT,PT,IVC,and HA to diagnose significant liver inflammation were 0. 804,0. 722,0. 707,and 0. 632,respectively. The cut - off value of 48. 5 U/ L for GGT to predict significant liver inflammation had a specificity of 90. 3% and a negative predictive value of 74. 6% . Conclusion GGT,PT,IVC,and HA are independent predictors for significant liver inflammation in CHB patients with ALT <2 × ULN,among which GGT has the highest predictive value. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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