ALT和HBV DNA联合诊断e抗原阴性的慢性活动性乙型肝炎诊断界值的建立及评价

doi:10.3969/j.issn.1673-8640.2014.05.012

检验医学 ›› 2014, Vol. 29 ›› Issue (5): 483-487.DOI: 10.3969/j.issn.1673-8640.2014.05.012

ALT和HBV DNA联合诊断e抗原阴性的慢性活动性乙型肝炎诊断界值的建立及评价

刘伟平¹, 易琴², 殷明刚¹

1.自贡市第一人民医院检验科, 四川自贡 643000;
2.成都医学院医学检验系, 四川成都 610083

收稿日期:2013-05-19 出版日期:2014-05-30 发布日期:2014-05-27
作者简介:刘伟平, 男, 1980年生, 硕士, 主管技师, 主要从事临床免疫学检验和分子生物学检验研究。

Establishment and assessment of the cut-off value for ALT and HBV DNA combination determination to diagnose HBeAg negative chronic active hepatitis B

LIU Weiping¹, YI Qin², YIN Minggang¹.

1.Department of Clinical Laboratory, Zigong First People′s Hospital, Sichuan Zigong 643000, China;
2.Department of Laboratory Medicine, Chengdu Medical College, Sichuan Chengdu 610083, China

Received:2013-05-19 Online:2014-05-30 Published:2014-05-27

摘要/Abstract

摘要： 目的建立和评估丙氨酸氨基转移酶(ALT)、乙型肝炎病毒(HBV) DNA和天门冬氨酸氨基转移酶(AST)对乙型肝炎e抗原(HBeAg)阴性活动性乙型肝炎的诊断界值(Cut-off值)。方法将290例HBeAg阴性的慢性乙型肝炎患者以肝组织活检结果为标准分为活动性(213例)和非活动性(77例)慢性乙型肝炎, 用受试者工作特征(ROC)曲线评价ALT、 AST 和 HBV DNA 载量在诊断HBeAg阴性的活动性慢性乙型肝炎中的价值。结果血清中ALT、AST、HBV DNA载量的ROC曲线下面积(AUC)分别为0.849、0.807、0.867;诊断界值为男性ALT 30 IU/L、女性ALT 19 IU/L, HBV DNA载量1×10⁵拷贝/mL时的敏感性为90.6%、特异性为98.7%、阳性预测值为99.5%、阴性预测值为79.2%;AST以40 IU/L作为Cut-off值时的敏感性为77.0%、特异性为63.3%、阳性预测值为85.4%、阴性预测值为50.0%。结论可以以男性ALT 30 IU/L、女性ALT 19 IU/L且HBV DNA载量1×10⁵拷贝/mL作为中国四川自贡地区HBeAg阴性的慢性活动性乙型肝炎的诊断Cut-off值。

关键词: 丙氨酸氨基转移酶, 天门冬氨酸氨基转移酶, 乙型肝炎病毒脱氧核糖核酸, 诊断界值, 慢性乙型肝炎

Abstract: Objective To establish and assess the cut-off value for alanine aminotransferase(ALT), hepatitis B virus (HBV) DNA and aspartate aminotransferase(AST) to diagnose hepatitis B e antigen (HBeAg) negative chronic active hepatitis B. Methods A total of 290 HBeAg negative chronic hepatitis B patients were enrolled and classified into 2 groups: active (213 cases) and inactive(77 cases) groups according to liver biopsy. The diagnosis significance for ALT, AST and HBV DNA load in HBeAg negative chronic active hepatitis B was evaluated by receiver operating characteristic (ROC) curves. Results The areas under ROC curve (AUC) for serum ALT, AST and HBV DNA load were 0.849, 0.807 and 0.867, respectively. For the cut-off values of 30 IU/L for male ALT and 19 IU/L for female ALT and HBV DNA load 1×10⁵ copies/mL, the sensitivity was 90.6%, the specificity was 98.7%, the positive predictive value was 99.5%, and the negative predictive value was 79.2%. The sensitivity of 77.0%, specificity of 63.3%, positive predictive value of 85.4% and negative predictive value of 50.0% were also observed for AST 40 IU/L as the cut-off value. Conclusions The 30 IU/L for male ALT and 19 IU/L for female ALT and HBV DNA load 1×10⁵ copies/mL are suggested to be the cut-off values for discriminating HBeAg negative chronic active hepatitis B.

Key words: Alanine aminotransferase, Aspartate aminotransferase, Hepatitis B virus deoxyribonucleic acid, Cut-off value, Chronic hepatitis B

中图分类号:

R446.61

刘伟平, 易琴, 殷明刚. ALT和HBV DNA联合诊断e抗原阴性的慢性活动性乙型肝炎诊断界值的建立及评价[J]. 检验医学, 2014, 29(5): 483-487.

LIU Weiping, YI Qin, YIN Minggang.. Establishment and assessment of the cut-off value for ALT and HBV DNA combination determination to diagnose HBeAg negative chronic active hepatitis B[J]. , 2014, 29(5): 483-487.

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ALT和HBV DNA联合诊断e抗原阴性的慢性活动性乙型肝炎诊断界值的建立及评价

Establishment and assessment of the cut-off value for ALT and HBV DNA combination determination to diagnose HBeAg negative chronic active hepatitis B

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