血清总胆汁酸、胆碱酯酶在婴儿肝病诊治中的意义

Significance of Serum Total Bile Acid and Cholinesterase in Diagnosis and Treatment of Infantile Hepatopathy

目的探讨血清总胆汁酸(TBA)、胆碱酯酶(CHE)在婴儿肝病中的意义。方法婴儿肝病60例分别为母乳性黄疸、巨细胞病毒(CMV)性肝炎及先天性胆道畸形患儿,选择20例正常婴儿作为对照组;检测血清TBA、CHE水平。并对CMV性肝炎患儿急性期和恢复期进行自身对照比较。结果正常对照组、母乳性黄疸、巨细胞病毒性肝炎及先天性胆道畸形各组TBA分别为(6.47±3.25)、(8.71±1.79)、(45.86±40.85)(、119.50±31.73)μmol/L;CHE分别为(11295.50±1731.91)、(10762.89±1237.30)、(9771.32±860.27)(、7967.304±31.58)U/L。其中CMV性肝炎及先天性胆道畸形两组TBA、CHE在与各组两两比较中均有显著性差异(P均<0.01),先天性胆道畸形组改变最明显;CMV性肝炎急性期和恢复期TBA比较有明显差异(P<0.05,P<0.01),淤胆型患儿CHE恢复期明显升高(P<0.05)。结论在婴儿肝病诊治中,检测TBA、CHE有助于及早对病因、病情、预后作出判断和估计。

Objective To explore clinical value of serum total bile acid（TBA） and cbolinesterase（CHE） in infantile hepatopathy. Methods Sixty infants diagnosed respectively with breast milk jaundice, cytomegalovirus hepatitis and congenital bile duct teratism were included. Twenty healthy infants were as control. The infants of cytomegalovirus hepatitis were ,self- compared in acute stage and convalescence stage. Serum TBA and CHE in every group were measured and compared. Results Serum TBA in control group, breast milk jaundice group, cytomegalovirus hepatitis group and congenital bile duct teratism group were （6.47 ± 3.25）, （8.71 ± 1.79）, （45.86 ± 40.85）, （ 119.50 ± 31.73 ） μmol/L, respectively; and CHE were （ 11295.50 ± 1731.91 ）, （ 10762, 89 ± 1237.30）, （9771.32 ± 860.27）, （7967. 304 ± 31. 58） U/L, respectively. Compared with other groups, the level of serum TBA and CHE in cytomegalovirus hepatitis group and the congenital bile duct teratism group were significantly different（all P〈0.01 ）. And in the congenital bile duct teratism group, the level was the most impressive. Serum TBA of cytomegalovirus hepatitis group had significant difference in the acute stage and convalescence stage（ P〈0.05, P〈0.01 ）. Serum CHE of cholestatic infantile cytomegalovirus hepatitis showed a significant increase in convalescence stage（P〈0.05）. Conclusion The measurement of serum TBA and CHE is important in judging and estimating etiological factor, state of illness and prognosis of infantile hepatopathy.