2022 年第 2 期 第 17 卷

白蛋白与碱性磷酸酶比值对乙型肝炎肝硬化的预测价值

Predictive value of albumin-to-alkaline phosphatase ratio in hepatitis B cirrhosis

作者：刘丽1王言言1田玉峰2高春海1

英文作者：Liu Li1 Wang Yanyan1 Tian Yufeng2 Gao Chunhai1

单位：1山东省临沂市人民医院检验科，临沂276003；2山东省日照市人民医院检验科，日照276826

英文单位：1Department of Clinical Laboratory Linyi People′s Hospital Shandong Province Linyi 276003 China; 2Department of Clinical Laboratory People′s Hospital of Rizhao Shandong Province Rizhao 276826 China

关键词：乙型肝炎病毒；乙型肝炎肝硬化；白蛋白与碱性磷酸酶比值

英文关键词：HepatitisBvirus;HepatitisBcirrhosis;Albumin-to-alkalinephosphataseratio

• 摘要：

• 目的  探讨白蛋白与碱性磷酸酶（ALP）比值(AAPR)对乙型肝炎肝硬化的预测价值。方法  收集2019年10—12月于临沂市人民医院就诊的慢性乙型肝炎病毒（HBV）感染患者122例作为研究对象，其中47例为慢性乙型肝炎（乙型肝炎组）、75例为乙型肝炎肝硬化（乙型肝炎肝硬化组）。另选取同期于本院体检中心体检健康者60例为健康对照组。比较3组血清白蛋白、ALP水平及AAPR。采用受试者工作特征(ROC)曲线分析AAPR对乙型肝炎肝硬化的预测价值。结果  健康对照组血清白蛋白水平和AAPR均高于乙型肝炎组和乙型肝炎肝硬化组［（47.3±2.5）g/L比（44.0±4.9）、（33.7±8.4）g/L，（0.70±0.16）比（0.55±0.13）、（0.35±0.15）］，且乙型肝炎组均高于乙型肝炎肝硬化组，健康对照组和乙型肝炎组ALP水平低于乙型肝炎肝硬化组［（71±15）、（85±26）U/L比（115±58）U/L］，差异均有统计学意义（均P＜0.05）。ROC曲线分析结果显示，AAPR预测乙型肝炎肝硬化的曲线下面积为0.901（95%置信区间：0.855~0.947，P＜0.001），最佳临界值为0.41，敏感度和特异度分别为76.0%和92.5%。结论  AAPR对乙型肝炎肝硬化具有一定的预测价值。

• Objective To investigate the predictive value of albumin-to-alkaline phosphatase (ALP) ratio (AAPR) in hepatitis B cirrhosis. Methods From October to December 2019, 122 patients with chronic hepatitis B virus (HBV) infection admitted to Linyi People′s Hospital were enrolled, including 47 cases with chronic hepatitis B (hepatitis B group)and 75 cases with hepatitis B cirrhosis (hepatitis B cirrhosis group). During the same period, 60 healthy volunteers undergone physical examination in the hospital were selected as the healthy control group. The serum albumin, ALP levels and AAPR were compared among groups. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of AAPR in hepatitis B cirrhosis. Results The level of serum albumin and AAPR in healthy control group were higher than those in hepatitis B group and hepatitis B cirrhosis group［（47.3±2.5）g/L vs （44.0±4.9）,（33.7±8.4）g/L;（0.70±0.16） vs （0.55±0.13）,（0.35±0.15）］, those in hepatitis B group were higher than those in hepatitis B cirrhosis group, ALP level in health control group and hepatitis B group was lower than that in hepatitis B cirrhosis group［（71±15）,（85±26）U/L vs （115±58）U/L］, and the differences were significant different (all P<0.05). ROC curve analysis showed that the area under the curve for AAPR predicting hepatitis B cirrhosis was 0.901(95% confidence interval: 0.855-0.947, P<0.001), the best cut-off value was 0.41, the sensitivity was 76.0% and the specificity was 92.5%. Conclusion AAPR has certain predictive value in hepatitis B cirrhosis.