病毒性肝炎慢性HBV携带者血清中肝功能相关蛋白检测的临床意义

摘要

目的：了解慢性HBV携带者血清中肝功能相关蛋白胆碱脂酶（ChE）、白蛋白（Alb）、前白蛋白（PA）、转铁蛋白（TRF）、铁蛋白（FRT）、C反应蛋白（CRP）、铜蓝蛋白（CER）的水平，并且探讨这些蛋白对慢性HBV携带者的诊断价值。方法选取2012年1月至2014年7月在重庆医科大学附属永川医院就诊的86例慢性HBV携带者作为观察组，另外选取102例健康体检者作为对照组，分别检测其血清中ChE、Alb、PA、TRF、FRT、CRP、CER等生化指标，并对部分观察组人群进行肝穿刺活组织检查。计量资料组间比较采用独立样本t检验。结果观察组与对照组的CER水平分别为（0．20±0．04）g／L、（0．29±0．06）g／L，差异有统计学意义（t＝2.03，P＝0．03），其他指标差异均无统计学意义（P值均＞0．05）；观察组中，肝脏炎症程度高或纤维化程度高的患者血清中CER水平下降明显，差异均有统计学意义[（0．23±0．01）g／L vs （0．18±0．02）g／L，t＝－2．6，P＝0．01；（0．22±0．02）g／L vs （0．17±0．04）g／L， t＝－3．2，P＝0.004）。结论血清中CER水平的变化能反映早期肝脏炎症和纤维化程度，并可能成为慢性HBV携带者早期诊断与治疗的重要指标。%Objective To investigate the serum levels of liver function-related proteins (cholinesterase,ChE;album,Alb,prealbumin, PA;transferrin,TRF;ferritin,FRT;C-reactive protein,CRP;and ceruloplasmin,CER)and assess their clinical diagnostic significance for chronic hepatitis B virus (HBV)carriers.Methods The study selected 86 HBV carriers who were diagnosed in the Affiliated Yong-Chuan Hospital of Chongqing Medical University from January 2012 to July 2014 (the observation group).Additionally,102 healthy individ-uals who underwent physical examination in the hospital were selected (the control group).Biochemical indices including serum ChE,Alb, PA,FRT,TRF,CRP,and CER levels were measured in both groups.Liver biopsy was performed in part of the observation group.Group comparison of continuous data was performed using the independent-samples t test.Results Serum CER levels in the observation and con-trol groups were (0.20 ±0.04)g/L vs (0.29 ±0.06)g/L,showing a statistically significant difference (t=2.03,P=0.03).No signifi-cant differences occurred in the rest of biochemical indices between groups (P>0.05 for all).Serum CER levels were significantly de-creased in patients with higher severity of liver inflammation and fibrosis [(0.23 ±0.01)g/L vs (0.18 ±0.02)g/L,t=-2.6,P=0.01;(0.22 ±0.02)g/L vs (0.17 ±0.04)g/L,t=-3.2,P=0.004].Conclusion The change in serum CER level can reflect the severity of liver inflammation and fibrosis in the early stage.Thus,serum CER level may become an important index for early diagnosis and treatment of HBV carriers.