|
|
|
| Clinical Value of Serum Cholinesterase in Evaluating Liver Injury Induced by Antituberculosis Therapy in Patients with HBV Infection and Pulmonary Tuberculosis |
| LIN Tao |
| Fushun Central Hospital, Liaoning Fushun 113008, China |
|
|
|
|
Abstract Objective: To analyze the clinical value of serum cholinesterase (CHE) in evaluating liver injury induced by antituberculosis therapy in patients with hepatitis B virus (HBV) infection and pulmonary tuberculosis. Methods: 112 cases of patients with HBV infection and pulmonary tuberculosis (combined group), 94 cases of patients with simple pulmonary tuberculosis (simple group) and 102 healthy subjects (healthy group) were enrolled in the study. All patients with pulmonary tuberculosis received antituberculosis treatment. Serum CHE levels and liver function indexes were detected, and the correlation between CHE and liver function indexes was analyzed. Results: During the treatment, the normal rate of liver function, the mild injury rate and the severe injury rate in the combined group were 16.07%, 44.64% and 39.29%, respectively while those in the simple group was 21.28%, 61.70% and 17.02%, respectively (P<0.05).The serum CHE level ranged from high to low were the combined group, the simple group and the healthy group, and the difference was statistically significant (P<0.05), and the more serious liver injury, the lower serum CHE level (P<0.05). After treatment, the levels of HBV-DNA quantification, total bilirubin(TBIL), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of the combined group were significantly increased (P<0.05), while CHE level was significantly decreased (P<0.05). Serum CHE was negatively correlated with TBIL, ALT and AST (r=-0.712, 0.723,0687, P<0.05). The ROC curve results of liver injury induced by anti tuberculosis treatment and analyzed by serum CHE showed that the area under the curve was 0.912 (P<0.05) and the diagnostic critical value was 4325.54U/L, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of serum CHE diagnosis were 91.49%, 83.33%, 96.63%, 65.22% and 90.18% with high diagnostic efficiency. Conclusion: Serum CHE can well reflect the degree of liver injury and high diagnostic efficiency in patients with HBV infection and pulmonary tuberculosis during antituberculosis treatment, which provides references for early antiviral therapy.
|
|
|
|
|
|
[1] 任易,彭孝红,徐晶,等.肺结核和肺外结核患者外周血淋巴细胞亚群及血液相关指标的变化比较[J].医学临床研究,2017,34(1):173~175.
[2] 林日暇,冯伯荣,林昌锋,等.联合应用利福喷丁与对氨基水杨酸异烟肼治疗难治性肺结核86例临床疗效观察[J].湖南师范大学学报:医学版,2016,13(5):90~92.
[3] 张强军,张晓明.活动性及非活动性肺结核CT征象对不同类型肺结核的鉴别诊断价值[J].中国CT和MRI杂志,2017,15(1):67~69.
[4] 厉景南,李朝霞,任琅,等.拉米夫定治疗初治涂阳肺结核合并乙肝病毒携带者的临床疗效及对T淋巴细胞的影响[J].中国基层医药,2015,22(2):295~297.
[5] 苏智祥,张燕军,刘爱琴,等.替比夫定与恩替卡韦在非霍奇金淋巴瘤合并乙型肝炎病毒感染患者化疗中的抗病毒作用研究[J].蚌埠医学院学报,2016,41(8):1000~1002.
[6] 杨春生,梁金山,刘艳梅,等.肝硬化患者联合检测腺苷脱氨酶、胆碱酯酶、纤维蛋白原及D二聚体的临床意义[J].血栓与止血学,2013,19(1):23~24.
[7] 中华医学会结核病学分会.肺结核诊断和治疗指南[J].中华结核和呼吸杂志,2001,20(2):70~74.
[8] 程海林,胡旭东,龚凤云,等.肺结核合并乙型肝炎病毒感染患者抗结核治疗过程中血清γ干扰素变化的临床意义[J].临床内科杂志,2016,33(6):400~402.
[9] 杨成云,万映兰,李梦君,等.抗结核治疗导致乙型肝炎病毒再激活3例[J].中国医药导报,2015,12(14):144~146.
[10] 刘建锋,雷建平,邓群,等.初治结核病患者抗结核治疗致肝损伤169例临床分析[J].中国防痨杂志,2014,36(1):67~69.
[11] 吴侠.血清前清蛋白和胆碱酯酶测定对肺结核治疗患者肝脏合成功能损伤的评价作用[J].中国全科医学,2010,13(26):2990~2991.
[12] 于佳,王玲玲,冯佳,等.乙型肝炎肝硬化患者血清胆碱酯酶活性与Child-Pugh分级的相关性研究[J].医学综述,2016,22(9):1845~1847.
[13] 张永杰,薛玉保,朱子元.晚期肝细胞癌患者血清胆碱酯酶水平与FOLFOX 4一线治疗预后相关性分析[J].中华肿瘤防治杂志,2015,22(19):1556~1560.
[14] 闫福堂,王华,孙惠平,等.69例肺结核患者血清胆碱酯酶活性变化分析[J].现代检验医学杂志,2012,27(2):112~113.
[15] 许俊,倪正义,龚凤云.肺结核合并慢性肝病抗结核药物性肝损害的临床观察[J].中西医结合肝病杂志,2016,26(6):349~350.
[16] 李文红,王芳,付莹,等.肺结核药物性肝损害的相关因素分析[J].临床肺科杂志,2016,21(11):2097~2100.
[17] 唐开斌.活血化瘀方对慢性乙型肝炎肝纤维化生化指标及肝功能的影响[J].四川中医,2015,33(6):74~75. |
|
|
|
2018, Vol. 24 
