【摘要】 目的探讨联合检测肝硬化患者血清中总胆汁酸(TBA)、前白蛋白(PA)、胆碱酯酶(CHE)对肝硬化及其分级的临床价值。方法随机搜集不同病因所致肝硬化患者30例,根据child-turcottee-pugh分级法分为ChildA级(8例),ChildB级组(10例),ChildC级组(12例),与健康体检者30例作为对照组比较,分别取静脉血测定血清总胆汁酸、前白蛋白、胆碱酯酶水平,并进行腹部彩超检查了解肝、脾、腹水情况以及脑电图了解脑电活动情况。结果①与对照组比较,肝硬化时患者总胆汁酸早期即可明显升高,而前白蛋白、胆碱酯酶含量逐渐下降,差异有统计学意义(t值分别为3.03,P值﹤0.05、t=2.042,P值﹤0.05、2.75,P值﹤0.01)。②在肝功能分级不同阶段,上述各项指标亦有显著差异。结论总胆汁酸、前白蛋白、胆碱酯酶是反映肝脏储备功能、合成功能以及肝脏损伤的重要指标,故联合检测有利于更全面的评价肝功能,且更有利于对肝硬化的早期诊断、分级、手术时机的选择、以及更好帮助临床判断预后。更多还原

【Abstract】 OBJECTIVE To evaluate the clinical values of measuring the serum total bile acid, prealbumin and cholinesterase for the cirrhosis and its classification. METHODS Randomly collected 30 patients with cirrhosis induced by different causes, who were divided into 3 groups according to child-turcottee-pugh classification (group Child A 8 cases, Child B 10 cases and Child C 12 cases). And chose the 30 controls in the control group, took the vein blood for detecting the levels of serum total bile acid, prealbumin, cholinesterase abodomen ultrasound and EEG was performed to evaluate the liver, spleen, ascites and brain function. RESULTS ① Compared to the control group, total bile acid rose apparently in early cirrhosis, prealbumin, cholinesterase decreased by and by, the difference was significant (t = 3.03, P﹤0.05; t = 2.042, P﹤0.05; t = 2.75, P﹤ 0.01). ② At different grades of child-turcottee-pugh, the above items had also significant differences. CONCLUSION Total bile acid, prealbumin and cholinesterase are the important indexes for detecting the liver reserve function, composition function and liver injury, so measuring the items together will benefit for the diagnosis of early cirrhosis, child-turcottee-pugh classification, the timing of operations and judgment of the prognosis.更多还原