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血清谷胱甘肽还原酶活性水平评估乙型肝炎肝损伤患者的临床价值

The clinical value of serum glutathione reductase activity in the evaluation of hepatitis B patients with liver injury
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摘要 目的探讨血清谷胱甘肽还原酶(GR)活性水平与乙型肝炎(简称乙肝)肝损伤的相关性及其临床应用价值。方法收集430例表观健康标本(对照组)和606例乙肝患者标本(肝损伤组),检测血清GR活性水平及其他肝功能标志物水平。采用组内和组间单因素分析、多重线性回归分析和二分类Logistic回归分析评估GR活性水平与乙肝肝损伤的相关性。结果组间比较,肝损伤组总体GR活性水平、男性和女性GR活性水平均明显高于对照组,差异均有统计学意义(P<0.001);组内比较,对照组男性GR活性水平明显高于女性,差异有统计学意义(P<0.05)。多因素线性回归分析结果显示,肝损伤患者GR活性水平与年龄、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和碱性磷酸酶(ALP)均呈正相关(r=0.095、0.331、0.113、0.319,P<0.001、<0.001、=0.009、<0.001)。多因素二分类Logistic回归分析结果显示,GR活性水平升高是肝损伤的独立因子(OR=1.086,P<0.001)。受试者工作特征曲线分析结果显示,血清GR活性水平对乙肝患者肝损伤的诊断界值为59.5 U/L,ROC曲线下面积(AUC)为0.899(95%CI 0.881~0.918,P<0.001),灵敏度为82.7%,特异度为85.3%。不同因子间AUC比较,GR的诊断效能次于ALT和AST,但优于总胆红素和ALP。结论血清GR活性水平升高是肝损伤的独立危险因子,可作为临床诊断、评估肝损伤的辅助指标。 Objective To investigate the relationship between serum activity levels of glutathione reductase(GR)and hepatic damage induced by hepatitis B,and its potential of clinical applications.Methods A total of 430 apparently healthy subjects(control group)and 606 patients with hepatitis B(hepatic damage group)were enrolled in the study.The serum activity levels of GR and the levels of other hepatic biomarkers were determined.The relationship between GR and hepatic damage induced by hepatitis B was analyzed by intra-and inter-group univariate analysis,multivariate linear regression analysis and multivariate binary Logistic analysis.Results Inter-group comparation showed that the overall activity levels of GR and male and female actirity levels of GR were significantly higher in hepatic damage group than those in control group,and the differences were statistically significant(P<0.001).Intra-group comparison showed that the activity levels of GR of males were significantly higher than those of females in control group,and the difference was statistically significant.Multivariate linear regression analysis showed that the activity levels of GR in patients with hepatic damage was positively correlated with age,alanine aminotransferase(ALT),aspartate aminotransferase(AST)and alkaline phosphatase(ALP)(r=0.095,0.331,0.113,0.319,P<0.001,<0.001,=0.009,<0.001).Multivariate binary Logistic analysis showed that the increasing of activity level of GR was an independent indicator for the occurrence of hepatic damage(OR=1.086,P<0.001).The optimal cut-off value of serum activity level of GR for predicting hepatic damage in patients with hepatitis B was found as 59.5 U/L in receiver operating characteristic(ROC)curve analysis,which yielded an area under curve value of 0.899(95%CI:0881-0.918,P<0.001)and demonstrated a sensitivity of 82.7%and a specificity of 85.3%.Compared among AUCs of different indicators,the diagnostic potent of GR was second to those of ALT and AST,but stronger than those of total bilirubin and ALP.Conclusion The in
作者 李淑丽 陆善词 王军 杨海辉 何娟 梁连辉 高文军 LI Shuli;LU Shanci;WANG Jun;YANG Haihui;HE Juan;LIANG Lianhui;GAO Wenjun(Department of Clinical Laboratory,Guangdong Zhongshan Second People′s Hospital,Zhongshan,Guangdong 528447,China;Department of Medical Education,Guangdong Zhongshan Second People′s Hospital,Zhongshan,Guangdong 528447,China;Department of Hepatology,Guangdong Zhongshan Second People′s Hospital,Zhongshan,Guangdong 528447,China)
出处 《国际检验医学杂志》 CAS 2020年第15期1844-1848,共5页 International Journal of Laboratory Medicine
基金 广东省中山市医学科研项目(2018A020345)。
关键词 谷胱甘肽还原酶 肝损伤 乙型肝炎 glutathione reductase hepatic damage hepatitis B
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