中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2011年
8期
603-607
,共5页
孙静%于红卫%刘钊%刘晖%张强%姚勤伟%冯岩梅%李娟%孟庆华
孫靜%于紅衛%劉釗%劉暉%張彊%姚勤偉%馮巖梅%李娟%孟慶華
손정%우홍위%류쇠%류휘%장강%요근위%풍암매%리연%맹경화
肝炎,慢性%病理学%丙氨酸氨基转移酶%天冬氨酸氨基转移酶%酶-胆分离
肝炎,慢性%病理學%丙氨痠氨基轉移酶%天鼕氨痠氨基轉移酶%酶-膽分離
간염,만성%병이학%병안산안기전이매%천동안산안기전이매%매-담분리
Hepatitis,chronic%Pathology%Alanine transaminase%Aspartate transaminase%Enzyme bilirubin separate
目的 研究慢性重型肝炎患者的病理诊断与临床诊断的符合率,筛选与病理诊断符合率高的临床诊断指标.方法 选取2004年11月-2009年6月于北京佑安医院住院并进行肝移植的病例,筛选出临床诊断为慢性乙型重型肝炎和(或)病理诊断为慢性乙型重型肝炎的病例为研究对象.检测患者白细胞、血小板、平均红细胞体积、总胆红素、直接胆红素、白蛋白、ALT、AST、尿素氮、肌酐、血糖、胆碱酯酶、总胆固醇、γ-谷氨酰转移酶、碱性磷酸酶、血清钾、血清钠、凝血酶原活动度及血氨水平,彩色超声检查测量门静脉宽度及脾静脉厚度,并对其在不同组别患者间的差别进行比较.2组间数据比较用独立样本t检验,3组间数据比较用F检验.结果 51例患者中,临床及病理诊断符合率64.7%.慢性重型肝炎组ALT及AST分别为(675.0±510.0)U/L和(392.0±370.0)U/L,均高于活动性肝硬化组的(67.0±45.0)U/L和(103.0±59.0)U/L(t值分别为2.349和2.332,P值均＜0.01);慢性重型肝炎组中发病时间＜30d者的ALT为(761.0±743.0)U/L,明显高于发病时间≥30d者的(117.0±112.0)U/L(t=2.928,P＜0.01);慢性重型肝炎组和活动性肝硬化组的酶-胆分离现象发生率分别为78.9%及0.结论 慢性乙型重型肝炎的临床与病理诊断符合率不高,观察ALT和AST升高幅度及疾病过程中有无酶-胆分离现象有助于提高慢性重型肝炎的诊断符合率.
目的 研究慢性重型肝炎患者的病理診斷與臨床診斷的符閤率,篩選與病理診斷符閤率高的臨床診斷指標.方法 選取2004年11月-2009年6月于北京祐安醫院住院併進行肝移植的病例,篩選齣臨床診斷為慢性乙型重型肝炎和(或)病理診斷為慢性乙型重型肝炎的病例為研究對象.檢測患者白細胞、血小闆、平均紅細胞體積、總膽紅素、直接膽紅素、白蛋白、ALT、AST、尿素氮、肌酐、血糖、膽堿酯酶、總膽固醇、γ-穀氨酰轉移酶、堿性燐痠酶、血清鉀、血清鈉、凝血酶原活動度及血氨水平,綵色超聲檢查測量門靜脈寬度及脾靜脈厚度,併對其在不同組彆患者間的差彆進行比較.2組間數據比較用獨立樣本t檢驗,3組間數據比較用F檢驗.結果 51例患者中,臨床及病理診斷符閤率64.7%.慢性重型肝炎組ALT及AST分彆為(675.0±510.0)U/L和(392.0±370.0)U/L,均高于活動性肝硬化組的(67.0±45.0)U/L和(103.0±59.0)U/L(t值分彆為2.349和2.332,P值均＜0.01);慢性重型肝炎組中髮病時間＜30d者的ALT為(761.0±743.0)U/L,明顯高于髮病時間≥30d者的(117.0±112.0)U/L(t=2.928,P＜0.01);慢性重型肝炎組和活動性肝硬化組的酶-膽分離現象髮生率分彆為78.9%及0.結論 慢性乙型重型肝炎的臨床與病理診斷符閤率不高,觀察ALT和AST升高幅度及疾病過程中有無酶-膽分離現象有助于提高慢性重型肝炎的診斷符閤率.
목적 연구만성중형간염환자적병리진단여림상진단적부합솔,사선여병리진단부합솔고적림상진단지표.방법 선취2004년11월-2009년6월우북경우안의원주원병진행간이식적병례,사선출림상진단위만성을형중형간염화(혹)병리진단위만성을형중형간염적병례위연구대상.검측환자백세포、혈소판、평균홍세포체적、총담홍소、직접담홍소、백단백、ALT、AST、뇨소담、기항、혈당、담감지매、총담고순、γ-곡안선전이매、감성린산매、혈청갑、혈청납、응혈매원활동도급혈안수평,채색초성검사측량문정맥관도급비정맥후도,병대기재불동조별환자간적차별진행비교.2조간수거비교용독립양본t검험,3조간수거비교용F검험.결과 51례환자중,림상급병리진단부합솔64.7%.만성중형간염조ALT급AST분별위(675.0±510.0)U/L화(392.0±370.0)U/L,균고우활동성간경화조적(67.0±45.0)U/L화(103.0±59.0)U/L(t치분별위2.349화2.332,P치균＜0.01);만성중형간염조중발병시간＜30d자적ALT위(761.0±743.0)U/L,명현고우발병시간≥30d자적(117.0±112.0)U/L(t=2.928,P＜0.01);만성중형간염조화활동성간경화조적매-담분리현상발생솔분별위78.9%급0.결론 만성을형중형간염적림상여병리진단부합솔불고,관찰ALT화AST승고폭도급질병과정중유무매-담분리현상유조우제고만성중형간염적진단부합솔.
Objective To study the coincidence rate of clinical diagonisis with pathological diagnosis for chronic severe hepatitis, and to screen out clinical indicators consistent with pathological diagnosis.Methods Fifty-one patients diagnosed as chronic severe hepatitis and underwent liver transplantation in Beijing You'an hospital from November 2004 to June 2009 participated in this study. The clinical data were selected as following: ALT, AST, urea nitrogen, creatininc, glucose, cholinesterase, total cholesterol, Glutamyl endopeptidase, alkaline phosphatase, serum potassium, serum sodium, prothrombin activity and blood ammonia level. The width of the portal vein and splenic vein thickness were measured by color Doppler ultrasound and were compared in different groups. Data were ananlyzed with independent sample t test and F test. Results The coincidence rate between clinical and pathological diagnoses in this study was 64.7%. ALT and AST levels for Chronic severe hepatitis and decompensated cirrhosis were 675.0 ± 510.0 U/L, 67.00 ± 45.0 U/L ( P ＜ 0.01) and 392.0 ±370.0 U/L, 103.0 ± 59.0 U/L(P ＜ 0.01) respectively, with statistically significant difference existed. The mean level of ALT in Chronic severe hepatitis group was significantly different in the situations of onset less than 30 days or more than 30 days (means were 761.0 ± 743.0 U/L and 117.0 ± 112.0 U/L,P ＜ 0.01). The rate of the phenomenon of enzyme isolated bile in the chronic severe hepatitis and decompensated cirrhosis group were 78.9% and 0 respectively. Conclusions The coincidence rate of clinical with pathological diagnoses for Chronic Severe Hepatitis was low, increased ALT and AST levels would help improve the diagnostic accuracy.
