慢性乙肝4项临床指标联合检测在早期肝硬化快速筛查中的应用-东南大学学报医学版

慢性乙肝4项临床指标联合检测在早期肝硬化快速筛查中的应用

单位：苏州市第五人民医院传染科, 江苏苏州 215007

分类号：R512.6

出版年·卷·期（页码）：2017·36·第五期（833-837）

摘要：

目的：为了快速筛查和发现乙肝早期肝硬化患者，制定个体化治疗方案，降低肝硬化和肝癌的发生率，方法：以白细胞（WBC）、血小板（PLT）、凝血酶原时间（PT）和前白蛋白（PA）为主要乙肝临床检验联合筛查指标。结果：通过统计分析研究表明，乙肝早期肝硬化患者的白细胞（3.2×10⁹·L^-1）、血小板（68.3×10⁹·L^-1）和前白蛋白（137.2 mg·L^-1）等指标值均明显低于该3项指标的正常参考值下限（WBC值=4.0×10⁹·L^-1，PLT值=100.0×10⁹·L^-1，PA值=180.0 mg·L^-1）和无早期肝硬化患者的临床检验指标值（WBC值=5.2×10⁹·L^-1，PLT值=136.0×10⁹·L^-1，PA值=196.7 mg·L^-1）。对于PT，与无早期肝硬化患者PT参考值为12.8 s，而有早期肝硬化风险患者PT为16.4 s，存在3.4 s （>3 s，有意义）显著差异值。结论：通过联合比较WBC、PLT、PT、PA等临床检验指标值可以快速筛查具有早期肝硬化风险的乙肝患者，且当这4个指标值均介于乙肝早期肝硬化风险指标值时，快速筛选才出现仅有的6%的正误筛率。

Objective:For rapid screening and discovery of early liver cirrhosis risks of hepatitis B patients, the individualized treatments were carried out to decrease the ratios of liver cirrhosis and liver cancer. Methods:White blood cell (WBC), platelet (PLT), prothrombin time (PT) and prealbumin (PA) as the main clinical examination indexes were involved in the screening. Results:WBC (3.2×10⁹·L^-1), PLT (68.3×10⁹·L^-1) and PA (137.2 mg·L^-1) were much lower than those of the low limitation of the normal reference (WBC=4.0×10⁹·L^-1, PLT=100.0×10⁹·L^-1, PA=180.0 mg·L^-1) and other patients without early cirrhosis risks (WBC=5.2×10⁹·L^-1, PLT=136.0×10⁹·L^-1, PA=196.7 mg·L^-1), respectively. Compared with the CHB patients without early cirrhosis risks (PT=12.8 s), PT of the patients with early liver cirrhosis risks was 16.4 s (the D-value was 3.4 s>3.0 s) which was obviously longer, indicating a significant difference between general CHB patients and early cirrhosis risk CHB patients. Conclusion:By comparison the values of WBC, PLT, PT and PA, CHB patients with early liver cirrhosis risks could be screened. Meanwhile, when the four clinical examination indexes were between hepatitis B early cirrhosis risks index value, the positive error rate of the rapid detection was only 6%.

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