慢性乙型肝炎病人血清胆碱酯酶、甲胎蛋白变化的意义

Clinical significance of serum cholinesterase and alpha fetoprotein in chronic hepatitis B patients

目的 探讨慢性乙型肝炎病人血清胆碱脂酶、甲胎蛋白的变化规律及其临床意义。方法 按2000年修订的《病毒性肝炎防治方案》诊断标准，随机抽取218例轻度、中度、重度、重型及肝炎后肝硬化、肝癌病人，检测其血清胆碱脂酶、甲胎蛋白值。结果 与正常人相比，随着肝脏的损害加重，血清胆碱脂酶呈逐渐下降趋势，甲胎蛋白逐渐增高，统计学处理有显著差异。在重型肝炎病人，好转组胆碱脂酶、甲胎蛋白明显高于死亡组。结论 血清胆碱脂酶、甲胎蛋白是反映肝损害程度较敏感的指标，可作为临床诊断，鉴别、判断预后的参考依据。

Objective To appraise the law and clinical significance of variation of serum cholinesterase （ChE） and alpha fetoprotein （AFP） in all kinds of chronic hepatitis B （CHB） patients. Methods 218 patients were randomized into this study which was classified as mild, moderate and severe degrees of CHB, liver cirrhosis （LC）, hepatocarcinoma, and hepatic gravis groups. The serum concentrations of ChE and AFP were detected in these patients. Results The serum concentrations of ChE showed a significant downtrend in patients with mild, moderate and severe degrees of CHB, liver cirrhosis and hepatocarcinoma （F=123.26, P〈0.01）. And the AFP levels were increased significantly according to the severity of liver damage （F=14.25, P〈0.05）. In hepatic gravis patients, the levels of ChE and AFP in those medicable were higher than those of deteriorating individual Conclusions This data showed that the serum CHE and AFP can reflect partially the degrees of liver deterioration, and be regarded as a prediction for diagnosis, differentiation and prognosis in chronic hepatitis B patients.