Comparison Of Biochemical Indexes Of Liver And Gallbladder In Cholestasis Type Of Drug-induced Liver Injury And Analysis Of ROC Curve

Objective:To compare the characteristics of hepatobiliary biochemical indexes of cholestasis type of drug-induced liver injury and analyze the ROC curve.Methods:Collected cases diagnosed cholestasis caused by CBDS,PBC or DILI and admitted to the Second Hospital of Shanxi Medical University from January 2012 to July 2019.A total of 135 cases were divided into 3 groups,and the biochemical indexes of liver and gallbladder,for example ALT,AST,TBil,TBA,GGT,ALP and 5-NT,were recorded in each group.Use SPSS25 software to perform normality test,one-way analysis of variance,rank sum test,chi-square test and draw ROC curve analysis to get results.Results:The TBA level in DILI group was significantly higher than that in PBC group and CBDS group(P<0.05).The TBil level in DILI group was significantly higher than that in PBC group(P<0.05),but there was no difference between DILI group and CBDS group(P>0.05).The level of GGT in DILI group was significantly lower than that in CBDS group and PBC group(P<0.05).The level of 5-NT in DILI group was significantly lower than that in CBDS group(P<0.05),and there was no difference with PBC group(P>0.05).There was no difference in ALP level among DILI group,PBC group and CBDS group(P>0.05).In DILI group,ROC curve analysis showed that the area under curve of serum TBA was 0.990,P=0.000,the Cut-Off value was 120.2μmol/L,the sensitivity was 97.4% and the specificity was 100%;the area under ROC curve of the ratio of ALP to GGT was 0.930,P=0.000,the Cut-Off value was 0.74(1:1.35),the sensitivity was 89.5%,and the specificity was 89.5%;the area under ROC curve of serum TBil in DILI group was 0.751,P=0.000,the Cut-Off value was 171.62μmol/L,the sensitivity was 100% and the specificity was 55.8%;ROC curve analysis of serum ALP,5-NT and GGT levels had no significance.Conclusion:TBA level of DILI cholestasis type increased significantly,while 5-NT,ALP and GGT increased at a low level.The TBA level and the Cut-Off value of the ratio of ALP to GGT have high accuracy,sensitivity and specificity in diagnosing DILI cholestasis.