肝硬化患者前白蛋白、纤维蛋白原及肝纤维化指标与Child-Pugh分级的关系

Relationship among prealbumin,fibrinogen,liver fibrosis parameters and Child-Pugh class in patients with cirrhosis

目的:探讨肝硬化患者血清前白蛋白(PA)、血浆纤维蛋白原(FIB)及肝纤维化指标与Child-Pugh分级的关系。方法:肝硬化患者52例,按Child-Pugh分级,A级23例,B级16例,C级13例。正常对照组30例,男性18例,女性12例。均检测PA,FIB和肝纤维化指标透明质酸(HA)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(IV-C)、层粘连蛋白(LN)。结果:肝硬化患者PA,FIB含量均比对照组显著下降(P<0.01),肝纤维化指标HA,IV-C,PC-Ⅲ,LN含量均比对照组显著升高(P<0.01)。随着肝硬化Child-Pugh分级的递增,PA,FIB水平呈进行性下降,在C级处于最低水平,而肝纤维化指标水平均呈进行性升高,在C级均处于最高水平。PA与HA在肝硬化Child-Pugh A级、B级、C级组间两两比较差异有显著性(P<0.01)。结论:联合检测PA,FIB及肝纤维化指标HA,IV-C,PC-Ⅲ,LN可以较好反映肝硬化患者肝细胞受损的严重程度,对于观察病情、估计预后有一定的参考价值。

Objective： To investigate the relationship between prealbumin, fibrinogen changes of liver cirrhosis patients with different degree lesions in their liver. Methods： Fifty-two patients with liver cirrhosis were divided into three subgroups （A, B and C） on the base of Child-Pugh classification. Among the patients, 23 were classified as Child-Pugh class A, 16 were class B, 13 were class C. Thirty healthy individuals served as controls. A series of biochemistry and liver fibrosis parameters including Prealbumin （PA） , Fibrinogen （FIB）, HA, IV-C, PC-Ⅲ and LN were measured on 52 patients and the 30 healthy controls. Results： PA and FIB were progressively decreased from Child-Pugh class A to B and then to C. In comparison to the controls there was a significant difference （P 〈0.01 ）. HA, IV-C, PC-Ⅲ and LN were progressively increased from A to B and then to C. In comparison to the controls there was a significant difference （ P 〈0.01 ）. PA was negatively correlated to HA,IV-C,PC-Ⅲ and LN （P 〈0.01 ）, but FIB was not correlated to the liver fibrosis parameters （ P 〉 0. 01 ）. Conclusion： There was a closed relationship between PA, FIB, HA, IV-C, PC-Ⅲ, LN and Child-Pugh classification. PA was negatively correlated to the liver fibrosis parameters. Measuring the concentration of PA, FIB and liver fibrosis parameters simultaneously may have utilizable and reliable clinical value in predicting the degrees and prognosis of liver cirrhosis.