血清铜及血清游离铜对肝豆状核变性的诊断价值_张永红VIP免费

[文章编号]1671-587Ú(2009)01-0164-03[收稿日期]2008-05-24[基金项目]教育部高等学校博士学科点专项科研基金资助课题(20050533025)[作者简介]张永红(1965-),女,四川省广安市人,副教授,医学硕士,主要从事各种肝病的诊断和治疗研究。[通讯作者]张永红(Tel:0731-5292105,E-mail:zhangyongho@tom1com)血清铜及血清游离铜对肝豆状核变性的诊断价值张永红,杨旭,罗虹雨,雷建华,王文龙(中南大学湘雅二医院肝病中心,湖南长沙410011)[摘要]目的:探讨血清铜和血清游离铜对肝豆状核变性的诊断价值,为肝豆状核变性的诊断提供依据。方法:分别采用免疫散射比浊法和原子吸收光谱法检测8例暴发型肝豆状核变性、49例普通型肝豆状核变性、87例病毒性肝炎(慢性肝炎22例、重型肝炎46例、肝硬化19例)和57例其他肝病患者的血清铜蓝蛋白和血清铜,并根据血清铜和铜蓝蛋白计算出血清游离铜。结果:¹暴发型肝豆状核变性患者血清铜[(10510?2914)Lg#dL-1]高于普通型肝豆状核变性[(2811?1419)Lg#dL-1]和重型肝炎患者[(7015?4117)Lg#dL-1](P<0105);普通型肝豆状核变性患者血清铜均低于正常,与其他各组比较差异有显著性(P<0101);血清铜诊断肝豆状核变性敏感度为8610%,特异度为4712%。º暴发型肝豆状核变性患者血清游离铜平均为(6213?2717)Lg#dL-1,最高达113Lg#dL-1,明显高于其他各组(P<0101)。普通型肝豆状核变性的血清游离铜平均为(1012?913)Lg#dL-1,高于其他肝病组(P<0101),血清游离铜诊断肝豆状核变性的敏感度为5916%,特异度为100%。结论:血清铜和血清游离铜对肝豆状核变性的诊断有一定的参考价值,而血清游离铜可作为诊断暴发型肝豆状核变性的指标。[关键词]肝豆状核变性;铜蓝蛋白;血清铜;血清游离铜[中图分类号]R74214[文献标识码]ADiagnosticvalueofserumcopperandnon-ceruloplasmin-boundcopperdeterminationinpatientswithWilsondiseaseZHANGYong-hong,YANGXu,LUOHong-yu,LEIJian-hua,WANGWen-long(LiverDiseaseResearchCenter,SecondXiangyaHospital,CentralSouthUniversity,Changsha410011,China)Abstract:ObjectiveToinvestigatethediagnosticvalueofserumcopperandnon-ceruloplasmin-boundcopperdeterminationinpatientswithWilsondisease(WD)1MethodsCeruloplasminlevelwasmeasuredbyscatteringimmunoturbidimetricassayandserumcopperconcentrationbyflameatomicabsorptionspectroscopyatthediagnosisofpatientswithfulminantWilsondisease(FWD,8),non-fulminantWilsondisease(NFWD,49),viralhepatitis(chronichepatitis22,severehepatitis46,Cirrhosis19),andotherliverdiseases(57).Results¹TheaverageserumcopperconcentrationofpatientswithFWDwas(10510?2914)Lg#dL-1,whichwassignificantlyhigherthanthatofpatientswithNFWD(2811Lg#dL-1?1419Lg#dL-1)andseverehepatitis(7015Lg#dL-1?4117Lg#dL-1)(P<0105)1TheserumcopperconcentrationofpatientswithNFWDwaslowerthantheupperlimitofnormal,whichwassignificantlylowerthanthoseinothergroups(P<0101).Thesensitivityofserumcopperconcentrationwas8610%forthediagnosisofWD,andthespecificitywas4712%1ºTheaverageserumnon-ceruloplasmin-boundcopperconcentrationofpatientswithFWDwas(6213?2717)Lg#dL-1withmaximum113Lg#dL-1,whichwassignificantlyhigherthanthoseofothergroups(P<0101)1Theaverageserumnon-ceruloplasmin-boundcopperconcentrationofpatientswithNFWDwas(1012?913)Lg#dL-1,whichwassignificantlyhigherthanthoseofpatientswithotherliverdiseases(P<0101)1Thesensitivityofserumnon-164第35卷第1期2009年1月吉林大学学报(医学版)JournalofJilinUniversity(MedicineEdition)Vol.35No.1Jan.2009ceruloplasmin-boundcopperconcentrationwas5916%forthediagnosisofWDwithspecificity100%1ConclusionTheconcentrationsofserumcopperandserumnon-ceruloplamin-boundcopperarevaluableinthediagnosisofWD,andtheserumnon-ceruloplamin-boundcopperisaveryusefulparameterforthediagnosisandprognosisofFWD.Keywords:Wilsondise...