CAJ | 학술논문

目的：应用 Logistic 回归和受试者工作特征（ROC）曲线探讨抗－HCV S／CO 比值、AST、ALT 单项检测及联合检测诊断丙型肝炎现症感染的价值。方法留取588例酶联免疫吸附剂测定（ELISA）法检测血清抗－HCV 阳性标本，RT－PCR 法检测 HCV－RNA，酶速率法检测 AST、ALT，将标本分成 HCV－RNA 阴性组和阳性组，通过 Logistic 回归和 ROC 曲线对各指标进行分析。结果HCV－RNA 阳性组抗－HCV S／CO 比值、AST 水平、ALT 水平均高于 HCV－RNA 阴性组，差异均有统计学意义（ P＜0．05）。抗－HCV S／CO、AST、ALT 三者均与 HCV－RNA 呈正相关（ P ＜0．05），且相关程度为抗－HCV S ／CO ＞AST ＞ALT。抗－HCV S ／CO 比值、AST、ALT 单项的 ROC 曲线下面积（AUC）分别为0．894[95％ CI （0．862～0．926）]、0．823[95％ CI （0．789～0．856）]、0．788[95％ CI （0．750～0．826）]，三项联合检测的 AUC 为0．949[95％ CI （0．932～0．966）]，高于各指标单项检测的 AUC。结论诊断丙肝现症感染的指标中，抗－HCV 价值最大，其次分别为 AST、ALT，3项指标联合检测优于各指标单项检测。
목적：응용 Logistic 회귀화수시자공작특정（ROC）곡선탐토항－HCV S／CO 비치、AST、ALT 단항검측급연합검측진단병형간염현증감염적개치。방법류취588례매련면역흡부제측정（ELISA）법검측혈청항－HCV 양성표본，RT－PCR 법검측 HCV－RNA，매속솔법검측 AST、ALT，장표본분성 HCV－RNA 음성조화양성조，통과 Logistic 회귀화 ROC 곡선대각지표진행분석。결과HCV－RNA 양성조항－HCV S／CO 비치、AST 수평、ALT 수평균고우 HCV－RNA 음성조，차이균유통계학의의（ P＜0．05）。항－HCV S／CO、AST、ALT 삼자균여 HCV－RNA 정정상관（ P ＜0．05），차상관정도위항－HCV S ／CO ＞AST ＞ALT。항－HCV S ／CO 비치、AST、ALT 단항적 ROC 곡선하면적（AUC）분별위0．894[95％ CI （0．862～0．926）]、0．823[95％ CI （0．789～0．856）]、0．788[95％ CI （0．750～0．826）]，삼항연합검측적 AUC 위0．949[95％ CI （0．932～0．966）]，고우각지표단항검측적 AUC。결론진단병간현증감염적지표중，항－HCV 개치최대，기차분별위 AST、ALT，3항지표연합검측우우각지표단항검측。
Objective To evaluate the usefulness of anti -HCV signal-to-cutoff (S/CO)ratio, AST, ALT and the combined examination of anti-HCV S/CO, AST, ALT for predicting HCV RNA results by a model of logistic regression and receiver -operating characteristic (ROC) curve.Methods Five hundred and eighty -eight anti-HCV positive samples were tested by ELISA , followed by RT-PCR to detect HCV-RNA and enzyme rate method to detect AST, ALT.Patients were divided into viremia and non -viremia groups according to HCV-RNA results.Logistic regression and ROC curve analysis was performed to evaluate the diagnostic accuracy of each index for a diagnosis of viremia.Results The serum anti-HCV S/CO ratio, AST, ALT of HCV-RNA positive group were higher than HCV-RNA negative group, showing significant statistical difference ( P <0.05).Anti-HCV S/CO, AST and ALT has a closely posi-tive correlation with HCV-RNA ( P <0.05), anti-HCV S /CO >AST >ALT.The Area Under Curve(AUC) of the combined examina-tion of anti-HCV S/CO ratio, AST and ALT was 0.949(95% confidence interval,0.932 to 0.966), higher than the AUC of anti-HCV S/CO ratio, AST and ALT single index examinations , which was 0.894(95 % confidence interval, 0.862 to 0.926), 0.823(95%confidence interval, 0.789 to 0.856) and 0.788(95% confidence interval, 0.750 to0.826 ) respectively.C onclusions The diag-nostic relevance of the three biochemical markers for predicting the presence of viremia was anti -HCV S/CO ratio >AST >ALT.The combined examination of anti-HCV S /CO ratio, AST and ALT in predicting hepatitis C viremia is superior to any single index examina -tion and it can increase the detecting ability of HCV -RNA greatly.