目的 探讨慢性乙型肝炎、肝硬化、原发性肝癌患者血清甲胎蛋白(AFP)、糖链抗原125(CA125)、糖链抗原 199(CA199)、癌胚抗原(CEA)变化及其在肝脏损伤程度判断上的应用价值。方法 选取2014年6月-2016年12月我院 收治的145例慢性HBV感染者为研究对象，其中慢性乙型肝炎46例，肝硬化44例，乙肝肝癌55例，并选同期60例 健康体检者作为对照组，采用电化学发光法检测所有受试者血清AFP、CA125、CA199、CEA水平。结果 肝癌组、 肝硬化组、慢性肝炎组、对照组血清AFP水平分别为(60.34±10.68)ng/ml、(5.86±2.68)ng/ml、(4.46±1.64) ng/ml、(2.63±1.12)ng/ml，CEA水平分别为(2.62±2.11)ng/ml、(1.98±2.39)ng/ml、(1.49±2.13)ng/ml、 (1.84±1.21)ng/ml；肝癌组较其他三组血清AFP、CEA水平明显增高(P<0.05)，且随着病程发展，AFP、CEA水平逐 渐升高(P<0.05)。肝癌组、肝硬化组、慢性肝炎组、对照组CA125水平分别为(16.32±4.84）U/ml、(24.58±6.03) U/ml、(11.34±3.12)U/ml、(14.26±2.69)U/ml，肝硬化组较其他三组CA125水平明显增高(P<0.05)。各组血清 CA199水平比较无显著差异(P>0.05)。结论 对于乙肝肝病患者，CA125水平与病情严重程度呈正相关，且随着腹水 量严重程度逐渐增加，故CA125对于腹水变化监测及预后判断有重要价值。血清AFP、CEA随着肝病病程进展可出现 轻度升高，对早期肝癌亦可能存在一定监测价值。

Objective To investigate the changes of serum alpha fetoprotein (AFP), carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199) and carcinoembryonic antigen (CEA) in patients with chronic hepatitis B, liver cirrhosis and primary liver cancer, and their value in judging the degree of liver injury. Methods A total of 145 patients with chronic HBV infection (46 patients with chronic hepatitis B, 44 patients with cirrhosis and 55 patients with primary liver cancer) who were admitted to the hospital from June 2014 to December 2016 were selected as the subjects. At the same time, 60 healthy volunteers were selected as the control group. The serum AFP, CA125, CA199 and CEA levels were detected by electrochemiluminescence. Results Serum AFP levels in the liver cancer group, liver cirrhosis group, chronic hepatitis group and control group were (60.34±10.68) ng/ml, (5.86±2.68) ng/ml, (4.46±1.64) ng/ml and (2.63±1.12) ng/ml, respectively while CEA levels were (2.62±2.11) ng/ml, (1.98±2.39) ng/ml, (1.49±2.13) ng/ ml and (1.84±1.21) ng/ml, respectively. Serum AFP and CEA levels in the liver cancer group were significantly higher than those in the other three groups (P < 0.05), and levels of AFP and CEA increased gradually with the development of the disease (P<0.05). The CA125 levels in the liver cancer group, liver cirrhosis group, chronic hepatitis group and control group were (16.32±4.84) U/ml, (24.58±6.03) U/ml, (11.34±3.12) U/ml and (14.26±2.69) U/ml, respectively, and the CA125 level in the liver cirrhosis group was significantly higher than that in the other three groups (P<0.05). There was no significant difference in the CA199 level among the four groups (P>0.05). Conclusion The serum CA125 level is positively correlated with the severity of hepatitis B, and it increases gradually with the amount of ascites. Therefore, CA125 is of great value in monitoring changes of ascites and judging the prognosis. Serum AFP and CEA may increase slightly with the progression of liver disease, and they are of certain monitoring value for early liver cancer