血清胆碱酯酶活性对慢性乙型肝炎肝组织病理分级分期的预测价值

摘要

Objective To predict the hepatic pathological gradings and stagings by serum cholinesterase (Che)activity in patients with chronic hepatitis B. Methods 419 consecutive patients with chronic hepatitis B were enrolled in the present study,and their hepatic pathological diagnosis were made and serum Che activity were determined. Results There were significant differences of serum Che activity between G1 and G2,G2 and G3,G3 and G4 (P=0.000,0.000,0.014);There were significant differences of serum Che activity between S2 and S3,and S3 and S4 (P=0.000,0.000) ; The accurate rates by Che were 55.65％ for G1,28.25％ for G2,27.83％ for G3, and 66.67％ for G4; and 43.33％ for SO, 6.49％ for S1, 19.01％ for S2, 31.11％ for S3, and 71.29％ for S4; The areas under ROC curve of serum Che activity for diagnosing G4 and S4 were 0.868 and 0.831 (P=0.000 and 0.000) ;The optimal cutoff value of' serum Che activity for prodicting G4 and S4 were no more than 5.235×103u/L and 5.535×103u/L,respectively,and the sensitivity,specificity,and accuracy were 1.000 and 0.822,0.678 and 0.758, and 0.687 and 0.771,respectively. Concluson Serum Che activity is an index for prodicting G4 and S4 in patients with chronic hepatitis B.%目的 探讨血清胆碱酯酶活性对慢性乙型肝炎肝组织病理学分级和分期的预测价值.方法 419例慢性乙型肝炎患者行肝穿活检;采用Roche全自动生化分析仪检测血清胆碱酯酶活性.结果 血清胆碱酯酶活性在G1与G2、G2与G3、G3与G4之间均有显著性差异(P＝0.000、0.000、0.014),在S0与S1、S1与S2之间无显著性差异(P＝0.309、0.370),在S2与S3、S3与S4之间有显著性差异(P＝0.000、0.000);基于血清胆碱酯酶活性的判别函数预测G1、G2、G3、G4的正确率分别为55.65%、28.25%、27.83%、66.67%,预测S0、S1、S2、S3、S4的正确率分别为43.33%、6.49%、19.01%、31.11%、71.29%;血清胆碱酯酶活性预测G4和S4的ROC曲线下面积分别为0.868和0.831(P＝0.000和0.000),以血清胆碱酯酶活性≤5.235×103u/L和≤5.535×103u/L为标准,其预测G4和S4的灵敏度、特异度、准确度分别为1.000和0.822、0.678和0.758、0.687和0.771.结论 血清胆碱酯酶活性对预测慢性乙型肝炎肝组织G4和S4有一定的参考价值.