目的探讨血清视黄醇结合蛋白(RBP)在慢性乙型肝炎(CHB)和CHB后肝硬化(Lc)患者中的变化及其诊断意义。方法选择109例确诊的住院患者,其中CHB组51例,Lc组58例。对照组(HC)选择年龄、性别匹配的健康体检者56例。全自动生化分析仪检测患者血清RBP、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ谷氨酰转肽酶(GGT)、乳酸脱氢酶(LDH)、总胆红素(TBIL)、前白蛋白(PA)和白蛋白(ALB)。结果CHB组和Lc组血清RBP水平较对照组显著降低(CHB组与HC组:t=8.06,P〈0.01;Lc组与HC组:t=10.26,P〈0.01),且Lc组显著低于CHB组(t=3.4l,P〈0.01)。CHB组和Lc组患者血清RBP与PA存在显著正相关关系(CHB组:r=0.856,P〈0.01;LC组:r=0.737,P〈0.01),而且CHB组和LC组患者血清RBP与ALB也存在正相关关系(CHB组:r=0.571,P〈0.01;LC组:r=0.328,P〈0.05)。ROC曲线分析发现,CHB组和LC组曲线下面积分别为0.874和0.942。结论血清RBP在CHB和LC患者中显著降低,且随着病情加剧有降低的趋势,对于肝病的临床诊断和预后判断可能具有重要价值。
Objective To investigate clinical significance of serum retinol - binding protein(RBP) in chronic hepatitis B (CHB) and liver cirrhosis after hepatitis B infection (LC). Methods 109 hospitalized patients were involved in this study. They were 51 patients with CHB ,58 patients with LC. 56 healthy individuals were selected as the the health controls ( HC ). RBP, ALT, AST, GGT, LDH, TBIL, PA and ALB were analyzed by automatic biochemical analyzer. Results Decreased serum RBP was observed in patients with CHB and LC ( CHB vs. HC : t = 8.06, P 〈 0. 01 ;LC vs. HC :t = 10.26, P 〈 0.01 ). In addition, the concentration of serum RBP in group of LC was lower than that in CHB( t =3.41 ,P 〈 0. 01 ). RBP was positively correlated with PA in patients with CHB and LC (CHB: r = 0. 856, P 〈 0.01 ; LC : r = 0. 737, P 〈 0.01 ), and RBP was positively correlated with ALB in patients with CHB and LC ( CHB : r = 0. 571, P 〈 0. 01 ; LC : r = 0. 328, P 〈 0. 05 ). ROC analysis showed that area under the receiver operator characteristic curve (AUC) in CHB and LC were 0. 874 and 0. 942, respectively. Conclusion Serum RBP decreases significantly in patients with CHB and LC. Serum level of RBP is associated with severity of liver diseases and maybe a potential prognostic index for liver disease.