目的：探讨血清甲胎蛋白（AFP）、丙酮酸激酶M2（M2‐PK）、清蛋白（ALB）联合检测在肝硬化诊断中的临床价值。方法将2011年3月至2013年3月成都市妇女儿童中心医院收治的178例各类肝病患者按照疾病类型分为急性肝炎组52例、慢性肝炎组57例、肝硬化组69例，另选择同期健康体检的健康者60例作为对照组，对比各组研究对象的血清AFP、M2‐PK、ALB水平。结果与对照组相比，急性肝炎组、慢性肝炎组、肝硬化组血清AFP、M2‐PK水平均明显升高，ALB明显降低，组间相比差异有统计学意义（P＜0．05）；与其他3组相比，肝硬化组血清AFP、M2‐PK水平最高，ALB水平最低（P＜0．05）。AFP、M2‐PK水平随着Child‐Pugh分级增高而升高，ALB水平随着Child‐Pugh分级增高而降低，组间相比差异有统计学意义（P＜0．05）。AFP、M2‐PK、ALB联合检测能够提高检测特异性和准确性。结论AFP、M2‐PK、ALB联合检测在肝硬化诊断中有较高的临床应用价值。%Objective To investigate the clinical value of combination detection of peripheral alpha fetoprotein (AFP) ,pyruvate kinase M2(M2‐PK)and albumin(ALB) in the diagnosis of liver cirrhosis .Methods 178 cases of va‐rious liver diseases in the Chengdu Municipal Women and Children Central Hospital from March 2011 to March 2013 were divided into the acute hepatitis group(52 cases) ,chronic hepatitis group(57 cases)and liver cirrhosis group(69 cases)according to the types of disease;at the same period 60 individuals with healthy examination were selected as the control group .The serum levels of AFP ,M2‐PK and ALB were compared among 3 groups .Results Compared with the control group ,serum AFP ,M2‐PK levels in the acute hepatitis group ,the chronic hepatitis group and the cir‐rhosis group were significantly increased ,ALB was significantly decreased ,the difference was statistically significant (P<0 .05);compared with the other three groups ,serum AFP ,M2‐PK levels in the hepatic cirrhosis group were highest ,the serum ALB level was lowest(P<0 .05) .The serum AFP ,M2‐PK levels were increased with the increase of the Child‐Pugh grade ,and the serum level of ALB was decreased with the increase of the Child‐Pugh grade ,differ‐ences between them were statistically significant(P<0 .05) .The combined detection of AFP ,M2‐PK and ALB could improve the detection specificity and accuracy .Conclusion The combination detection of AFP ,M2‐PK and ALB has the higher clinical application value in the diagnosis of liver cirrhosis.
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