目的应用受试者工作特征曲线(ROC曲线)探讨肝生化指标在燃煤型砷中毒中的诊断价值。方法2014年1月以贵州省兴仁县燃煤型砷中毒病区为调查点,采用生物化学法检测调查对象肝生化指标。绘制ROC曲线并计算曲线下面积(AUC)。结果砷中毒组血清总蛋白(TP)、白蛋白(ALB)含量和白球比(A/G)均低于对照组(P<0.01),碱性磷酸酶(ALP)活性和总胆汁酸(TBA)含量均高于对照组(P<0.05);中、重度砷中毒组血清谷氨酰胺转移酶(γ-GT)高于对照组(P<0.05);与对照比较,轻度组ALB、A/G、TBA、TP、ALP的AUC分别为0.79、0.71、0.64、0.63、0.60(P<0.05);敏感度A/G>ALP>ALB>TBA>TP;中度组ALB、TBA、A/G、TP、ALP、γ-GT的AUC值分别为0.86、0.81、0.76、0.67、0.61、0.59(P<0.05),TBA>ALB>A/G>ALP>TP>γ-GT。重度组ALB、TBA、A/G、TP、ALP、γ-GT的AUC值分别为0.89、0.87、0.79、0.72、0.67、0.63(P<0.01),TBA>A/G>ALB>TP>ALP>γ-GT。结论 ALB、TBA含量和A/G有助于砷中毒的早期诊断及分度诊断;TP、ALP、γ-GT可作为砷中毒辅助诊断和分度诊断的参考指标。 Objective To investigate the diagnostic value of liver biochemical markers in coal-burning arsenic poisoning by using receiver operating characteristic curve (ROC curve). Methods In January 2014, a coal-poisoned arsenism area in Xingren County, Guizhou Province was used as the investigation site. Biochemical methods were used to detect the liver biochemical indexes of the investigated subjects. Draw ROC curves and calculate the area under the curve (AUC). Results The levels of total protein (TP) and albumin (ALB) and white ball ratio (A / G) in arsenism group were lower than those in control group (P <0.01), ALP activity and total bile acid ) Were higher than those of the control group (P <0.05). The levels of serum glutamitransferase (γ-GT) in moderate and severe arsenism patients were higher than those in the control group (P <0.05) A / G, TBA, TP and ALP were 0.79,0.71,0.64,0.63,0.60 respectively (P <0.05); the sensitivity of A / G> ALP> ALB> TBA> The AUC values ​​of G, TP, ALP and γ-GT were 0.86,0.81,0.76,0.67,0.61,0.59 respectively (P <0.05), and TBA> ALB> A / G> ALP> TP> γ-GT. The AUC values ​​of ALB, TBA, A / G, TP, ALP and γ-GT in severe group were 0.89,0.87,0.79,0.72,0.67,0.63 (P <0.01) > γ-GT. Conclusion ALB, TBA content and A / G contribute to the early diagnosis and index diagnosis of arsenic poisoning. TP, ALP and γ-GT can be used as a reference index for auxiliary diagnosis and index diagnosis of arsenic poisoning.