血清纤维化指标联合AFP和铁蛋白检测在肝硬化患者Child-Pugh分级中的价值

检验医学 ›› 2014, Vol. 29 ›› Issue (12): 1222-1225.

血清纤维化指标联合AFP和铁蛋白检测在肝硬化患者Child-Pugh分级中的价值

王丰园¹, 章林华¹, 赖卫强²

1.玉环县人民医院检验科，浙江玉环 317600；2.台州市中心医院检验科，浙江台州 318000

收稿日期:2014-07-28 出版日期:2014-12-30 发布日期:2015-01-14
作者简介:王丰园,男,1962年生,主管技师,主要从事肝病检验工作。

The significance of the combined detection of AFP and ferritin with serum hepatic fibrosis indices in Child-Pugh classification among patients with liver cirrhosis

WANG Fengyuan¹, ZHANG Linhua¹, LAI Weiqiang²

1. Department of Clinical Laboratory, Yuhuan County People's Hospital, Zhejiang Yuhuan 317600, China; 2. Department of Clinical Laboratory, Taizhou Central Hospital, Zhejiang Taizhou 318000, China

Received:2014-07-28 Online:2014-12-30 Published:2015-01-14

摘要/Abstract

摘要：

目的　探讨肝硬化患者血清纤维化指标、甲胎蛋白（AFP）及铁蛋白三者与Child-Pugh分级的相关性，明确三者对肝功能的评价价值。方法　选择128例肝硬化患者为病例组，其中乙型病毒性肝炎后肝硬化67例，酒精性肝硬化48例，丙型病毒性肝炎后肝硬化13例；128例肝硬化患者Child-Pugh分级情况:A级45例，B级49例，C级34例。选择同期健康体检者50名为对照组。两组均抽取静脉血联合检测血清肝纤维化指标、AFP及铁蛋白表达水平。结果　随着肝硬化程度的加重，Child-Pugh分级由A级提高至C级，血清肝纤维化指标、AFP及铁蛋白亦逐渐上升，并且与Child-Pugh分级成显著相关性。结论　肝硬化患者血清肝纤维化指标、AFP及铁蛋白与肝硬化严重程度有一定的相关性，联合检测对客观评估肝硬化的严重程度及其预后有较高的参考价值。

关键词: 肝纤维化指标, 甲胎蛋白, 血清铁蛋白, 肝硬化

Abstract:

Objective　To investigate the correlations of serum hepatic fibrosis indices， alpha fetoprotein（AFP） and ferritin with Child-Pugh classification among patients with liver cirrhosis and their significance. Methods　A total of 128 patients with liver cirrhosis were enrolled， including viral hepatitis B（67 cases）， alcoholic liver cirrhosis（48 cases） and viral hepatitis C（13 cases）. Child-Pugh classification of these patients were A（45 cases）， B（49 cases） and C（34 cases）. A total of 50 healthy subjects were enrolled as control group. Venous blood was extracted for serum fibrosis indices， AFP and ferritin determinations. Results　With the severity of liver cirrhosis， Child-Pugh classification increased from A to C， and serum fibrosis， AFP as well as ferritin also gradually increased. There was a significant correlation with Child-Pugh classification. Conclusions　Serum fibrosis indices， AFP and ferritin are all related with the severity of liver cirrhosis. The combined detection has high reference significance for evaluating the severity and prognosis of liver cirrhosis.

Key words: Hepatic fibrosis index, Alpha fetoprotein, Serum ferritin, Liver cirrhosis

中图分类号:

R446.11

王丰园, 章林华, 赖卫强. 血清纤维化指标联合AFP和铁蛋白检测在肝硬化患者Child-Pugh分级中的价值[J]. 检验医学, 2014, 29(12): 1222-1225.

WANG Fengyuan, ZHANG Linhua, LAI Weiqiang. The significance of the combined detection of AFP and ferritin with serum hepatic fibrosis indices in Child-Pugh classification among patients with liver cirrhosis[J]. , 2014, 29(12): 1222-1225.

参考文献

[1] Bugaev N, Breeze JL, Daoud V, et al. Management and outcome of patients with blunt splenic injury and preexisting liver cirrhosis[J].J Trauma Acute Care Surg, 2014, 76(6): 1354-1361.
[2] Ishizu-Higashi S, Seno H, Nishi E, et al. Deletion of nardilysin prevents the development of steatohepatitis and liver fibrotic changes[J]. PLoS One, 2014, 9(5):e98017.
[3] Nemiroff J, Baharestani S, Juthani VV, et al. Cirrhosis-related coagulopathy resulting in disseminated intravascular coagulation and spontaneous orbital hemorrhages[J]. Orbit, 2014, 33(5):372-374.
[4] 柴艳峰.血清铁蛋白与肝硬化Child-Pugh分级的关系[J].中华全科医学,2009, 7(5): 497-498.
[5] Zhu J, Jiang F, Ni HB, et al. Combined analysis of serum γ-glutamyl transferase isoenzyme Ⅱ, α-L-fucosidase and α-fetoprotein detected using a commercial kit in the diagnosis of hepatocellular carcinoma[J].Exp Ther Med, 2013, 5(1): 89-94.
[6] Nassir F, Ibdah JA.Role of mitochondria in nonalcoholic fatty liver disease[J]. Int J Mol Sci, 2014, 15(5): 8713-8742.
[7] Wilder J, Patel K. The clinical utility of Fibro Scan (&#x0dbc0;&#x0ddbf;) as a noninvasive diagnostic test for liver disease[J]. Med Devices (Auckl), 2014, 7: 107-114.
[8] Ning ZW, Zhang WY, Li Y, et al. Inhibitory effect of angiotensin (1-7) on hepatic sinusoid angiogenesis in bile duct ligation-induced hepatic fibrosis of rats[J]. Zhonghua Gan Zang Bing Za Zhi, 2013, 21(12): 907-913.
[9] Wendt AS, Jefferds ME, Perrine CG, et al. Obese women less likely to have low serum ferritin, Nicaragua[J]. Public Health Nutr, 2014, 22: 1-6.
[10] Shimoni A.Risk stratification of patients with multiple myeloma prior to autologous stem cell transplant: what is the role of serum ferritin levels[J]. Leuk Lymphoma, 2014, 16: 1-2.
[11] Mecklenburg I, Reznik D, Fasler-Kan E, et al. Serum hepcidin concentrations correlate with ferritin in patients with inflammatory bowel disease[J].J Crohns Colitis, 2014.[Epub ahead of print]
[12] Bargellini I, Scionti A, Mismas V, et al. Identification of responders to sorafenib in hepatocellular carcinoma: is tumor volume measurement the way forward[J]. Oncology, 2014, 86(4): 191-198.
[13] 毛敬珍,崔凤芹,高俊英. 肝硬化患者血清AFP含量变化的临床观察[J]. 医学理论与实践, 2000, 13(5): 272-273.

[1]	中国康复医学会医学检验与康复专业委员会, 上海市医学会分子诊断专科分会, 上海市免疫学会肿瘤免疫分会, 上海中医药大学附属岳阳中西医结合医院, 上海市临床检验中心, 中国中西医结合学会检验医学专业委员会, 上海市抗癌协会检验医学专业委员会, 上海市抗癌协会肿瘤标志物专业委员会. 肝癌三项（AFP、AFP-L3%、DCP）与GALAD、类GALAD模型临床应用专家共识[J]. 检验医学, 2023, 38(7): 607-623.
[2]	顾怡, 王蕊, 邓杰, 杨易静, 周王柯, 陈予诺, 陈小松, 沈薇, 周景艺. 重症肝炎和肝硬化患者肝移植前后生物标志物水平差异及其预后评估价值[J]. 检验医学, 2023, 38(11): 1044-1051.
[3]	吴苏君, 冀恒涛, 彭梦乐. IL-18、IL-37、NLRP3及NK/DC比值在乙型肝炎相关肝硬化中的临床价值[J]. 检验医学, 2022, 37(6): 518-523.
[4]	孟俊, 王俊青, 费晓春, 顾志冬. 血浆外泌体circRNA诊断HCC联合检测模型的建立与验证[J]. 检验医学, 2022, 37(1): 1-10.
[5]	胡涛, 卢仁泉, 郭林. TK1检测在HCC辅助诊断及预后评估中的临床价值[J]. 检验医学, 2021, 36(9): 914-919.
[6]	包大伟, 黄建. CD133和ALDH1在肝细胞肝癌中的临床价值[J]. 检验医学, 2021, 36(9): 925-928.
[7]	王宇, 张雯雯, 刘美玲, 刘晓娟. 孕中期孕妇血清AFP、free-βHCG、uE3与GDM的关系[J]. 检验医学, 2021, 36(8): 828-832.
[8]	程惠芬. 血清P-选择素、ICAM-1、IL-17A水平在HBV感染相关疾病中的临床价值[J]. 检验医学, 2021, 36(6): 646-649.
[9]	刘婷婷, 林玉婷, 米拉, 李晓勤. 血清IL-33水平及其基因多态性与HBV感染临床转归的相关性[J]. 检验医学, 2021, 36(11): 1101-1105.
[10]	金方方, 金子铮, 刘宁, 娄金丽. 肝细胞肝癌复发前后CD3高表达T淋巴细胞的变化[J]. 检验医学, 2020, 35(3): 209-213.
[11]	孙慧冰, 李佩珊, 郭维龙, 李榕娇. 肝硬化患者血液中检出非O1非O139群霍乱弧菌1例报道[J]. 检验医学, 2020, 35(12): 1320-1322.
[12]	别立翰, 房萌, 冯惠娟, 陆志成, 高春芳. 唾液酸化触珠蛋白对乙型肝炎相关肝细胞肝癌的辅助诊断价值[J]. 检验医学, 2020, 35(11): 1147-1152.
[13]	李京华, 赵伟, 童晶晶, 张铁, 曹永彤. 原发性胆汁性肝硬化发生失代偿的危险因素研究[J]. 检验医学, 2018, 33(5): 399-403.
[14]	叶震璇, 杨必伟, 周雯婧, 刘强, 李红梅, 张海燕, 任智晶, 张华. 贵阳地区36 459名健康体检者抗M2型线粒体抗体筛查分析[J]. 检验医学, 2018, 33(3): 205-208.
[15]	康海岩, 郝若飞, 任赐菊. 血管紧张素Ⅱ水平与肝硬化严重程度的相关性[J]. 检验医学, 2018, 33(12): 1112-1115.