摘要
目的:探讨胆囊结石患者异常肝功能指标对无症状胆总管结石的诊断价值。方法:收集507例手术治疗的胆囊结石患者临床资料,分析患者术前肝功能指标与合并无症状胆总管结石的关系,对有意义的指标构建受试者操作特征(ROC)曲线,评价其对合并无症状胆总管结石的诊断的敏感性和特异性。结果:除总胆红素(TBIL)外,直接胆红素(DBIL)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、碱性磷酸酶(AKP)、γ-谷氨酰基转移酶(GGT)的升高均与合并无症状胆总管结石有关(均P<0.05);ROC曲线分析显示,DBIL、ALT、AST、AKP、GGT的曲线下面积分别为0.548、0.546、0.584、0.734、0.850,对应的敏感度和特异性分别为46.4%、72.5%;33.3%、75.8%;48.8%、60.5%;72.6%、63.5%;75%、79.5%。结论:在各项肝功能指标中,GGT的升高对胆囊结石合并无症状胆总管结石的预判价值最大。
Objective： To investigate the diagnostic value of abnormal liver function parameters on the concomitant asymptomatic choledocholithiasis in cholecystolithiasis patients. Methods： The clinical data of 507 cholecystolithiasis patients undergoing surgical treatment were collected. The relations of the preoperative liver function parameters with the concomitant common bile duct stones were analyzed, and the receiver operating characteristic （ROC） curves for the to assess their sensitivities and specificities for diagnosis of the concomitant asymptomatic choledocholithiasis. Results： Except for total bilirnbin （TBIL）, the increases of the parameters that included the direct bilirubin （DBIL）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, alkaline phosphatase （AKP）, and y-glutamyltransferase （GGT） in the patients were significantly related to the concomitant asymptomaticcholedocholithiasis （P〈0.05）. The ROC curve analysis showed that area under the ROC curve of DBIL, ALT, AST, AKP and GGT was 0.548, 0.546, 0.584, 0.734 and 0.850, and their corresponding sensitivity was 46.4%, 33.3%, 48.8%, 72.6% and 75%, and specificity was 72.5%, 75.8%, 60.5%, 63.5% and 79.5%, respectively. Conclusion： Among the liver function parameters, the increased GGT level has the greatest value for the detection of cholecvstolithiasis with concomitant asvmptomatic choledocholithiasis.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2014年第2期166-169,共4页
China Journal of General Surgery
