ABSTRACT
Objective To explore the clinical application value of the prealbumin (PA),total bile acid (TBA),and red blood cell volume distribution width (RDW) in chronic liver disease.Methods Totally 393 cases of patients with chronic liver disease admitted by Xiangya Hospital of Central South University from March 2015 to March 2016 were selected as group observation,and were divided into chronic hepatitis,compensated liver cirrhosis,decompensated liver cirrhosis and primary liver cancer.At the same time,200 cases of healthy volunteers were collected as normal control.Serum prealbumin and total bile acids were tested as well as the RDW of all cases.SPSS 17.0 software was used for data statistics processing.The receiver-operating characteristic curve (ROC) was drawn to evaluate the diagnosis value of the indexes in chronic liver disease severity.Results PA in the observation group was significantly lower than normal control,while its TBA and RDW were significantly higher than normal control.All of three parameters in patients,especially with liver cirrhosis and decompensated liver cirrhosis,had higher positive rate.When the clinical diagnosis was taken as gold standard,the best level of PA to diagnose primary liver cancer,chronic hepatitis and decornpensated liver cirrhosis was 244.7 mg/L,238.5 mg/L and 132.8 mg/L,the AUC was 0.973,0.909 and 0.879,the sensitivity was 92.3％,95.1％ and 85.6％,and the specificity was 95.8％,72.8％ and 79.7％;the best level of RDW to diagnose primary liver cancer,chronic hepatitis and decompensated liver cirrhosis was 13.2％,13.8％ and 14.3％,the AUC was 0.816,0.827 and 0.818,the sensitivity was 66.7％,77.4％ and 72.2％,and the specificity was 79.5％,73.8％ and 77.3％.When combined detection of PA and RDW,the diagnostic performance had improved significantly.Conclusions Serum prealbumin and total bile acid,as well as the whole blood RDW may objectively reflect the injury of liver metabolism and synthesis function,and for the early diagnosis and prognosis of patients with chronic liver disease has a important clinical significance.