急性甲型肝炎患者血清丙氨酸氨基转移酶值与胆囊声像图变化的相关性探讨

Serum Alanine Transaminase and Gallbladder Ultrasonograms in Patients with Acute Hepatitis A:Correlation Study

目的探讨利用胆囊声像图变化来判断急性甲型肝炎患者的肝细胞损害程度。方法超声测量41例健康志愿者和33例急性甲型肝炎患者胆囊的长径和短径,以及急性肝炎患者胆囊壁的厚度,计算胆囊面积和胆囊壁厚-面积比;利用生化仪以速率法检测患者血清丙氨酸氨基转移酶(ALT);将肝炎组胆囊壁厚度、胆囊面积和胆囊壁厚-面积比分别与ALT值进行直线相关与回归分析比较。结果健康志愿组胆囊壁光整,壁厚为(0.11±0.07)cm,胆囊面积为(22.1±4.97)cm2。胆囊壁厚-面积比为(0.0095±0.0023)cm-1,ALT值为(23±11)IU/L。急性肝炎组的胆囊壁厚度为(0.82±0.22)cm,胆囊面积为(16.36±4.87)cm2,胆囊壁厚-面积比为(0.0517±0.0176)cm-1;ALT值为(1737.46±784.03)IU/L;以上参数(胆囊壁厚度、胆囊面积、胆囊壁厚-面积比、ALT值)与健康志愿组相应参数两两比较,差异具有显著性,P<0.05。急性肝炎组的ALT值与该组胆囊壁厚-面积比之间存在着直线回归和相关性,(Y=87.26+28477.79x,r=0.72,P<0.05);ALT值与胆囊壁厚度及胆囊面积之间无直线相关性。结论1.胆囊声像图的改变是可以反映ALT的高低,从而可间接反映肝脏实质细胞的损害程度,至少急性甲型肝炎患者如此;2.胆囊壁厚-面积比是判断肝细胞损害程度比较合适的超声观察指标。

Objective The aim of our study was to iudge the severity of hepatic cell impairment in patients with hepatitis A using gallbladder utrasonography. Methods The longitudinal and cross diameters （LD, CD）, the wall thickness （WT） of lhe gallbladder in 41 healthy volunteers and 33 patients with hepatitis A were measured on uhasonography. The gallbadder areas （A） and the ratios of WT and A were calculated in patients and the control. Alanine transaminase （ALT） in the patients and the control weredelaeted by rate method. The gallbladder WT, A and the ratios were analyzed respectively with ALT concentration by linear regression and linear correlation. Results In healthy group, the gallbladder walls were smooth, WT were 0.11±0. 07 era, A were 22.1±4.97 em^2, the ratios of WT and A were 0. 0095±0. 0023 cm^2, ALT were 23±11 IU/L; In acute hepatitis A group, WT were 0.82±0.22 cm, A were 16.36±4.87 cm^2, ; the ratios of WT and A were 0. 05174±0. 0176 cm^-1, ALT were 1 737.46±784.03 IU/L; These parameters （WT, A, ratio of WT and A, ALT） were significant difference between healthy group and acute hepatitis A group （P〈0.05）： There was linear regression and linear