肝硬变患者血清甘胆酸水平的临床意义

Clinical significance of serum cholylglycine levels in patients with liver cirrhosis

目的评估空腹血清甘胆酸（ＣＧ）测定对肝硬变患者的临床意义．方法肝硬变患者１０２例，采用放免法测定空腹血清甘胆酸水平．按Ｃｈｉｌｄ分级法将上述患者分为Ａ（２１例），Ｂ（３１例）和Ｃ（５０例）三级．结果本组１０２例患者中有９６０％（９８例）血清ＣＧ水平高于正常，其中ＣｈｉｌｄＡ级为９０５％，Ｂ和Ｃ级分别为９３５％和１００％．肝硬变Ｂ级（４４１μｍｏｌ／Ｌ±２８６μｍｏｌ／Ｌ）和Ｃ级（４４６μｍｏｌ／Ｌ±３３３μｍｏｌ／Ｌ）的ＣＧ水平明显高于Ａ级（１９５μｍｏｌ／Ｌ±１１６μｍｏｌ／Ｌ，Ｐ＜００１），但Ｂ，Ｃ两组间无差异（Ｐ＞０１）．血清ＣＧ水平与血清总胆红素之间呈正相关，而与血清白蛋白呈负相关．结论空腹血清ＣＧ测定有助于评估肝硬变的严重程度及预后．

AIM To evaluate the clinical significance of fasting serum levels of cholylglycine in patients with liver cirrhosis. METHODS Serum levels cholylglycine were measured by radioimmunoassay in 102 patients with cirrhosis, who were divided into groups A ( n =21), B( n =31) and C ( n =50) according to Child′s classification. RESULTS In cirrhotic patients, 96 0% (90 5% with Child′s A cirrhosis, 93 5% with B and 100% with C) had increased serum cholylglycine levels. Serum CG levels in group B (44 1μmol/L±28 6μmol/L) and C (44 6μmol/L±33 3μmol/L) were higher than that in group A (19 5μmol/L±11 6μmol/L), ( P <0 01), but there was no significant difference between group B and C ( P >0 1). Serum CG level correlated positively with the total serum bilirubin level and negatively with albumin. CONCLUSION Fasting serum CG level is a useful marker of severity in the evaluation and follow up of cirrhotic patients.