肝硬化患者血清中AST／ALT比值、总胆红素及凝血酶原时间对肝功能分级的价值

Value of Liver Function on Child-Pugh Classification by Serum AST/ALT Ratio, Total Bilirubin and Prothrombin Time in Patients with Cirrhosis

目的探讨肝硬化患者血清中AST／ALT比值、总胆红素及凝血酶原时间对肝功能分级的价值。方法测定96例肝硬化患者血清AST／ALT比值、总胆红素及凝血酶原时间，并与对照组60例比较。同时比较肝硬化不同Child-Pugh分级状态时这3项指标的差异。结果与对照组比较，肝硬化组的血清AST／ALT、总胆红素及凝血酶原时间均明显升高，差异有显著性意义（P〈0．001）。不同肝功能分级时血清AST／ALT、凝血酶原时间的测定值均随着肝功能分级递增而呈现上升趋势，各级之间差异具有显著性（P〈0．05）。总胆红素的测定值也随着肝功能分级递增而呈现上升趋势，B级与C级，A级与C级间差异有显著性，但A级与B级间差异无显著性意义（P〉0．05）。结论联合检测AST／ALT比值、总胆红素及凝血酶原时间可为临床评价肝硬化患者的肝功能及预后提供客观依据。

Objective To study the varieties of AST/ALT ratio, total bilirubin （TB）, prothrombin time（PT） in patients with liver cirrhosis and the relationship between these indictors and Child-Pugh classification. Methods Serum AST/ALT ratio, TB and PT were measured in 96 cases of liver cirrhosis and 60 healthy people in different grades of Child-Pugh classification. Results Serum AST/ALT ratio, TB and PT were significantly increased in patients with liver cirrhosis compared with healthy group （P 〈 0.001 ）. Meanwhile, AST/ALT ratio, TB and PT increased with the classification of liver function raised. The difference of AST/ALT ratio and PT in different classification of liver function was prominent （P 〈 0. 05, P 〈 0.001 ）. But the difference of TB was inconspicuous in Child-Pugh A and Child-Pugh B （P 〉 0.05 ）. Conclusion The combined detection of AST/ALT, TB and PT is considered to provide an objective basis for prognosis and clinical evaluation in liver function for oatients with cirrhosis.