血清总胆汁酸值对外科病人病情危重程度与预后的评估价值

Value of serum total bile acid level in assessing the severity and prognosis of critical surgical patients

目的：探讨血清总胆汁酸值与急性病理生理和慢性健康（ＡＰＡＣＨＥ－Ⅱ）评分之间的联系，及其对外科疾病严重程度和预后的评估价值。方法：对２１５例外科病人进行４５０例次的ＡＰＡＣＨＥ－Ⅱ，并同时测定血清总胆汁酸值。结果：随着ＡＰＡＣＨＥ－Ⅱ评分的增高血清总胆汁酸值呈相关递增，死亡病人死亡前的血清总胆汁酸值和ＡＰＡＣＨＥ－Ⅱ评分均较发病初期有显著增高（Ｐ＜０．０５）。结论：血清总胆汁酸值可作为评估外科危重疾病严重程度及预后判断的一项重要指标，具有与ＡＰＡＣＨＥ－Ⅱ评分系统相同的评估价值。

Objective: To evaluate the value of total bile acid and compare with APACHEⅡ scoring system in assessing the severity and prognosis of critical surgical patients. Method: 450 occasions of APACHEⅡ scoring and fasting serum total bile acid (TBA) determination were performed in 215 critical surgical patients. Results: Correlation analysis showed that fasting serum TBA levels were significantly and positively correlated to APACHEⅡ score. Serum TBA and APACHEⅡ score of patients before death were significantly higher than those patients at their earlier stage(P<005). Conclusion :The results suggest that serum TBA has the same value as APACHEⅡ score in assessing the severity and prognosis of critical surgical illnesses.