临床医学毕业论文慢性乙型肝炎患者血清afp动态监测临床意义

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1、XX大学毕业论文慢性乙型肝炎患者血清AFP动态监测临床意义姓名：2014年6月25日【摘耍】目的：动态监测慢性乙型肝炎患者血清甲胎蛋白(AFP)变化及肝功能指标，探讨慢性乙型肝炎各模式与AFP定量变化及肝功能改变的关系，高度警惕肝癌的发生。方法：对189例慢性乙型肝炎患者同时用ELISA法进行乙型肝炎五项血清学标志物、用RIA法进行AFP检测和谷丙转氨IW(ALT)、谷草转氨酶(AST)、谷胺酰转肽酶(GGT)和碱性磷酸酶(ALP)的水平检测。AFP升高者分别作B超、CT检查，排除肝癌后每2个月复查1次AFP、肝功、B超，连续进行

2、2a~5a追踪随访。结杲：189例中146例AFP不同程度和不同类型升高。随访中HBsAg、抗HBe及抗HBc3项阳性(即“小三阳。中发现AFP稳定上升型的11例(15.5%)均发展为肝癌；HBsAg、HBeAg及抗HBc3项阳性即“大三阳”屮发现AFP稳定上升型的3例(4.8%)发展为肝癌；HBsAg、抗HBc2项阳性组中1例AFP稳定上升型发展为肝癌。一过性升高和一直未升高型均未岀现肝癌。结论：慢性乙型肝炎小三阳感染模式动态监测AFP变化，对早期发现肝癌有重要价值。【关键词】慢性乙型肝炎；AFP；肝癌ClinicalSigni

3、ficanceofDynamicObservationonSerumAFPinPatientswithChronicHepatitisBVirusAbstract：ObjectiveMonitoringdynamiclevelofserumAFPandtheirmarkerofliverfunction,todiscusstherelationshipbetweenHBVinfectionmodesandAFPchangelevelandliverfunctioninpatientswithchronichepatitisBvir

4、us,andfindthediagnosticvalueaboutprimaryhepatocellularcarcinoma.MethodsHBVinfectionmodesaredetectedbyELISAandAFPbyRIAandALT,AST,GGT,ALPbybiochemicalassaysimultaneityin189patientswithchronichepatitisBvirus.Btypeultrasonicandcomputerizedtomography(CT)wereconductedonthos

5、ewhoseAFPrisewasfoundforthefirsttimesoastoexcludelivercancer,andthentheyweretestedonhepaticfunctionandretestedonAFPandBtypeultrasoniceverytwomonthsandwerefollowedupsuccessivelyuptotwoandfiveyears.ResultsOfthe189hepatitisBvirusinfectionchildrenpatients,146riseddissimil

6、arlyindegreeandtypeaboutAFPlevel.Accordingtothefollowup,11caseswhoseAFPlevelkeptrisingsteadilywithHBsAg>antiHBeandantiHBcpositivemodelsand3casewhosewhoseAFPlevelkeptrisingsteadilywithHBsAg>HBeAgandantiHBcpositivemodelsallbecameprimaryhepatocellularcarcinoma.ButNoliver

7、cancerwasfoundamongthosewhoseAFPlevelrisedephemerallyandwhoseAFPlevelneverrised.ConclusionItisvaluableforchronichepatitisBviruspatientswithHBsAg>antiHBeandantiHBcpositivemodelstodynamiciallyobserveonitsAFPlevel,theymayfindprimaryhepatocellularcarcinomaearlier.Keywords

8、：ChronichepatitisBvirus;AFP;Hepatocellularcarcinoma甲胎蛋口(AFP)主要是由胚胎肝细胞、卵黄囊和胃肠上皮细胞产生的一种特殊球蛋白。健康成年人血清AFP水平小于20ng/ml,1964年Tatari