甲胎蛋白检测在乙型肝炎病毒感染患者中的临床意义教案.docVIP

甲胎蛋白检测在乙型肝炎病毒感染患者中的临床意义 应盛 宁波市传染病医院传染科 摘要：目的 探讨甲胎蛋白(AFP)检测在HBV感染相关疾病中的临床意义和作用。方法 检测239名HBV感染患者为研究对象，无症状HBV携带组57人；慢乙肝组74人；慢乙肝合并肝硬化组63人；慢乙肝合并肝癌组45人和正常健康组40人血AFP水平，用logistic回归方法分析影响AFP升高的因素，用Spearmen等级相关方法分析AFP升高幅度与疾病严重程度的相关性。结果与正常健康者相比，慢性乙型肝炎、慢乙肝合并肝硬化、慢乙肝合并肝癌患者血中AFP、ALT、AST、TBIL水平明显增高，其中以慢乙肝合并肝癌患者血中AFP、TBIL水平最高，其次为慢乙肝合并肝硬化患者；ALT和AST在慢性乙型肝炎、慢乙肝合并肝硬化患者血中水平最高，其次为慢乙肝合并肝癌患者。回归分析结果提示慢乙肝、饮酒量、饮酒年数、年龄及ALT和AST与AFP20ng/ml相关；慢乙肝与AFP200ng/ml相关；AST与AFP400 ng/ml相关；总胆红素及直接胆红素与AFPl 000ng/ml相关。等级相关分析结果发现AFP升高幅度与疾病的严重程度有相关性(r=0．533，P0、01)。结论 AFP升高在不同HBV感染相关疾病组的临床意义有所不同；慢乙肝、饮酒、年龄及肝功能等因素可影响AFP的水平；AFP400ng/ml高度提示肝癌的发生, 动态检测AFP水平对判断HBV感染患者的预后具有重要的意义。 The Clinical Significance of Alpha-Fetoprotein Test in Hepatitis B Virus Infection Patients Abstract: Objective To explore the clinical significance of alpha-fetoprotein (AFP) detection in HBV infection-associated diseases. Method 239 HBV-infected patients were involved in the study. These patients were divided into asymptomatic HBV carrying group (57 cases); chronic hepatitis B group (74 cases); chronic hepatitis B cirrhosis group (63 cases); chronic hepatitis B with hepatocellular carcinoma (45 cases). The other normal group (40 cases) human was also included. Detection blood levels of AFP and using logistic regression analysis on the AFP elevated factor, with the Spearmen ranks correlation method of analysis of AFP increased severity of disease extent and relevance. Results Compared with normal group, chronic hepatitis B, chronic hepatitis B with cirrhosis, chronic hepatitis B with hepatocellular carcinoma in patients with serum AFP, ALT, AST, TBIL levels were significantly increased, of which the blood of chronic hepatitis B with hepatocellular carcinoma in patients with AFP, TBIL highest level, followed by chronic hepatitis B patients with cirrhosis. ALT and AST in chronic hepatitis B, chronic hepatitis B patients with cirrhosis of the highest level, followed by chronic hepatitis B patients with hepatocellular carcinoma. Regression anal