Studies On Clinical Significance Of Combined Determination Of Serum AST/ALT,ALB/CHE Ratios With Child-pugh Classification In Hepatic Cirrhosis

【Objective】To analyse the relationship between the changing rule of serum AST/ALT,ALB/ChEratios of the hepatic cirrhosis patients and the liver function, and the clinical significance;To learn about the influences of serum AST/ALT,ALB/ChE ratios on Child-Pughclassification;To combine the Child-Pugh classification with serum AST/ALT,ALB/ChEratios and comprehensively evaluate hepatic cirrhosis patients’ liver reserve function andthe extent of damage, in order to improve the accuracy of the Child-Pugh classification ofhepatic cirrhosis patients and provide a reliable basis for individualized treatmentprogram designing and the observation of curative effect.【Methods】Collecting the215case of hepatic cirrhosis patients at the infectious diseases andgastroenterology department of the General Hospital of Yan’an Medical University fromApril2013to December2013as the experimental group,and at the same time to thehospital examination of47cases of healthy people as the control group; Collection theselected patients’ clinical information, organize and record their age, gender,ALB,ChE,AST,ALT,and other related information. The experimental group by Child-Pughclassification into A, B, C three groups, calculating the MELD score of eachgroup.Application of SPSS17.0for data processing, all the data will be shown in the wayof mean±standard deviation(x±s),and the comparison between hepatic cirrhosis groupand the control group is to be made in t-test.The comparison of the Child-Pughclassification groups will be made in one-way ANOVA, and it shows the difference is ofstatistical significance with P<0.05;Analysing the correlation between Child-Pughintegral,MELD score and the serum AST/ALT, ALB/ChE ratios with the application ofSpearman correlation analysis; Analysing the influences of serum AST/ALT,ALB/ChEratios on Child-Pugh score in Multiple linear regression;The receiver operating characteristiccurve used to evaluate the veracity of each index diagnosing liver cirrhosis. 【Results】The serum AST/ALT,ALB/ChE ratios of hepatic cirrhosis group has risedsignificantly compared with that of the control group, the difference was statisticallysignificant (P <0.01);The level of serum AST/ALT,ALB/ChE ratios rises with the risingof Child-Pugh classification, and it is most obvious in the rising of Child-Pugh grade C.The comparative differences between the Child-Pugh classification and the ControlGroup and among the Child-Pugh classification themselves are both of statisticalsignificance(P<0.01);Through correlation analysis showed that the serum ALB/ChE ratioof the hepatic cirrhosis group has positive linear correlation with Child-Pugh integral andMELD score (r=0.682,0.595,P<0.01),and that serum AST/ALT ratio has positive linearcorrelation with Child-Pugh integration and MELD scores (r=0.502,0.503, P <0.01);Through Multiple linear regression analysis, serum AST/ALT,ALB/ChE ratios has asignificant influence on Child-Pugh integral; The areas under the ROC curve of serumAST/ALT, ALB/ChE ratios diagnosing hepatic cirrhosis are respectively0.801(95%CI:0.728-0.874) and0.859(95%CI:0.812-0.907),with the best cutoff value was1.45and0.85, the correspondent sensitivity was73.5%and68.8%, specificity was78.7%and93.6%.【Conclusion】Serum AST/ALT,ALB/ChE ratios can timely reflect liver function of the damage ofhepatic cirrhosis, and the ascending range is of certain value for evaluating the extent ofdamage of the hepatic cirrhosis patients’ liver function, also of important clinicalsignificance to learn about the liver reserve function and the illness state changes; SerumAST/ALT,ALB/ChE ratios has a significant influence on Child-Pugh integral, analysingthe hepatic cirrhosis patients’ condition by combining the Child-Pugh classification andthe serum AST/ALT,ALB/ChE ratios can make Child-Pugh classification more accurate,providing reliable basis for individualized treatment program designing and theobservation of curative effect; meanwhile the serum AST/ALT, ALB/ChE ratios, as thenon-invasive index for diagnosing hepatic cirrhosis,is of important reference value andbrings much convenience and practicality.