联合检测血清总胆汁酸和前清蛋白在肝脏疾病诊断中的应用

Application of combined detection of serum total bile acids and prealbumin in diagnosis of liver diseases

目的探讨联合检测血清总胆汁酸(TBA)和前清蛋白(PA)对肝脏疾病诊断的价值。方法对54例急性肝炎、54例慢性肝炎(轻度17例、中度25例、重度12例)、40例肝硬化(代偿期19例、失代偿期21例)、39例肝癌患者和50例健康对照者,空腹采集静脉血,用血清检测TBA、PA、总胆红素(TBiL)、丙氨酸氨基转移酶(ALT)、清蛋白(ALB)等肝功能指标,TBA采用两点速率法,PA采用透射免疫比浊法。结果急性肝炎、慢性肝炎轻度、慢性肝炎中度、慢性肝炎重度、肝硬化代偿期、肝硬化失代偿期、肝癌和健康对照组血清TBA分别是(179.3±69.5)μmol/L、(31.2±22.9)μmol/L、(48.6±26.5)μmol/L、(121.5±87.3)μmol/L、(54.1±34.3)μmol/L、(102.6±96.8)μmol/L、(64.5±39.7)μmol/L和(4.2±2.5)μmol/L,PA分别是(126.7±51.2)mg/L、(156.6±97.9)mg/L、(141.2±82.5)mg/L、(81.2±37.5)mg/L、(124.1±64.3)mg/L、(77.6±56.8)mg/L、(67.5±32.3)mg/L和(318.1±62.6)mg/L。各肝病组血清TBA明显比健康对照组高(P<0.05),而PA却均明显比健康对照组低(P<0.01)。结论血清TBA和PA为诊断肝脏疾病的一个敏感指标,联合检测TBA和PA有助于发现肝脏合成与代谢功能的早期损害。

Objective To study the value to diagnose liver diseases by combined detection of serum total bile acids （TBA） and prealbumin （PA）. Methods The TBA, PA, total bilirubin （TBil）, alanine aminotransferase （ALT） and albumin （ALB） were measured in 54 cases of acute hepatitis, 54 cases of chronic hepatitis （17 light degree,25 moderate degree, 12 serious degree）, 40 cawes of cirrhosis （19 compensation and 21 broken compensation）,39 cases of carcinoma liver and 50 healthy subjects. TBA was detected by two point rate assay and PA was detected using transmission immunoturbidimetry. Results In acute hepatitis, light chronic hepatitis, moderate chronic hepatitis, serious chronic hepatitis, compensatory cirrhosis, broken compensatory cirrhosis, carcinoma of liver group and healthy subjects, the levels of TBA were （179.3 ± 69.5）μmol/L,（31.2 ± 22.9） μmol/L, （48.6 ± 26.5） μmol/L, （121.5 ± 87.3） μmol/L,（54.1±34.3） μmol/L,（102. 6±96.8） μmol/L,（64.5±39.7） μmol/L and （4.2±2. 5） μmol/L, respectively; PAs were （126.7±51.2） mg/L, （156.6±97.9） mg/L, （141.2±82.5） mg/L, （81.2±37.5） mg/L, （124.1±64.3） mg/L, （77.6±56.8） mg/L,（67.5±32.3） mg/L and （318.1±62.6） mg/L, respectively. In all kinds of liver disease, the serum levels of TBA were higher significantly （P〈0. 05）, but PAs were obviously lower than that in the healthy subjects （P〈0. 01）. Conclusion There is a good sensitivity to diagnose liver diseases by combined detection of the serum total bile acids and prealbumin. They can provide a lot of information to help to find early damage of liver diseases about the function of synthesis and metabolism.