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1、·208·实用肝脏病杂志2004年11月第7卷第4期JClinHepatol,November2004.Vol.7,No.4·论著·血清胆碱酯酶活性对诊断亚急性乙型重型肝炎的价值探讨张占卿董华娟郝峥欧亚非黄绍萍朱翠云陆基华【摘要】目的探讨血清胆碱酯酶(Che)活性对亚急性乙型重型肝炎的诊断价值。方法常规检测亚急性乙型重型肝炎与急性肝炎患者血清Che活性,血清Che活性对亚急性乙型重型肝炎与急性乙型肝炎的鉴别价值分析采用ROC曲线法。结果亚急性重型肝炎血清Che活性(5447.7±2759.2)u/L,急性肝炎血清Che活性为11073.6±2911.7u/L,
2、两者相比有显著性差异(t=1.984,P=0.000)。鉴别亚急性重型肝炎与急性肝炎的血清Che活性的ROC曲线下面积0.915,显著大于标准参考线下面积(P=0.000)。以血清Che活性≥7548u/L诊断急性肝炎而排除亚急性重型肝炎的灵敏度、特异度和准确度分别为0.883、0.88和0.882,阳性和阴性预测值分别为0.958和0.710,阳性和阴性似然比分别为7.358和0.133。结论血清Che活性测定对排除亚急性重型肝炎有比较可靠的预测价值。【关键词】亚急性乙型重型肝炎急性乙型肝炎胆碱酯酶鉴别诊断Earlypredictivevalueofseru
3、mcholinesteraseforsubacuteseverehepatitisZhangZhanqing,DongHuajuan,HaoZheng,etal.MunicipalInfectiousDiseasesHospital,Shanghai200083,China【Abstract】ObjectiveToexplorethediagnosticvalueofserumcholinesterase(Che)forsubacuteseverehepatitis.MethodsSPSSsoftware10.0wasusedforstatisticanaly
4、sis.TtestwasusedforcomparingserumCheactivitiesbetweensubacuteseverehepatitisandacutehepatitis,andROCcurvemethodwasusedforanalyzingthevalueofserumCheactivitiesindiscriminatingsubacuteseverehepatitisfromacutehepatitis.ResultsSerumCheactivitiesinsubacuteseverehepatitisandacutehepatitis
5、were5447.7±2759.2u/Land11073.6±2911.7u/Lrespectively.TherewasanotablydifferenceinserumCheactivitiesbetweensubacuteseverehepatitisandacutehepatitis.TheareaundertheROCcurveofserumCheactivitiesfordiscriminatingsubacuteseverehepatitisfromacutehepatitiswas0.915,whichwassignificantlylarge
6、rthantheareaunderthestandardconferenceline.TakingserumChe≥7548u/Lascut2offfordiagnosingacutehepatitisandexcludingsubacuteseverehepatitis,thesensitivity,specificityandaccuracywere0.883,0.88and0.882respectively;thepositiveandnegativepredictivevaluewere0.958and0.710respectively;andthep
7、ositiveandnegativelikelihoodratiowere7.358and0.133.ConclusionSerumChedeterminationforexcludingsubacuteseverehepatitisfromacutehepatitisisveryreli2able.【Keywords】SubacuteseverehepatitisAcutehepatitisBCholinesteraseDifferentialdiagnosis胆碱酯酶(cholinesterase,Che)有两种:乙酰胆碱酯炎早期诊断的意义,较少有文献报道
8、。本文采用ROC酶(acetylcho
