病毒性肝炎患者血清胆碱酯酶、凝血酶原活动度检测的临床意义

Clinical significance of serum cholinesterase and prothrombin activity in patients with viral hepatitis

目的 研究血清胆碱酯酶 (CHE)、凝血酶原活动度 (PTA)与病毒性肝炎临床分型、病情及预后之间的关系。方法 分别采用酶速率法和比浊法测定 16 0例急性病毒性肝炎、慢性病毒性肝炎 (轻度、中度、重度 )、肝炎肝硬化患者血CHE和PTA ,其中 2 3例行肝穿病理诊断。结果 急性病毒性肝炎组CHE和PTA下降率分别为 0 .0 0 %和8.82 % ,急性病毒性肝炎组、慢性病毒性肝炎组、肝炎肝硬化组中CHE和PTA依次降低 (P <0 .0 1) ,且二者之间相关系数为 0 .75 2 (P <0 .0 1) ;12例血清CHE低于 1kU/L和PTA低于 2 0 %的肝硬化患者中 10例死亡 ,病死率为83.33% ,明显增高 (P<0 .0 1)。结论 血清CHE和PTA不能作为急性肝损伤指标 ,却是反映肝脏疾病慢性化、肝脏储备功能和再生功能的良好指标 。

Objective To investigate the relationship between serum cholinesterase(CHE), prothrombin activity (PTA) and the clinical type, disease condition and prognosis in the viral hepatitis patients. Methods Serum CHE in 160 patients with acute hepatitis, chronic hepatitis(mild,moderate and severe), cirrhosis was detected with enzyme rate method; Meanwhile, their plasma PTA was detected with turbidimetry test. Hepatic needle biopsy was conducted for pathological diagnosis in 23 cases. Results The decrease rate of CHE and PTA in the group of acute hepatitis was 0.00% and 8.82% respectively.The level of serum CHE and PTA decreased gradually in acute hepatitis, chronic hepatitis and cirrhosis(P< 0.01).The correlation coefficient between serum CHE and PTA was 0.752(P< 0.01). Out of 12 cirrhosis patients with the level of serum CHE and PTA under 1 kU/L and 20% respectively,10 died with fatality rate of 83.33%,showing significant increase(P< 0.01). Conclusion Serum CHE and PTA can not be regarded as serum markers for acute liver injury. However, they are sensitive markers for chronic transformation,hepatic reserve and regeneration,and more they are correlated with disease condition and prognosis.