肝病患者血清总胆汁酸测定的临床意义

Clinical Significance of Serum Total Bile Acid Determination in Patients with Hepatic Diseases

目的探讨肝脏疾病临床诊断中血清总胆汁酸(TBA)测定结果的临床意义。方法在日立7600型全自动生化分析仪上检测272例肝病患者(急性肝炎98例、慢性活动性肝炎54例、肝硬化71例和肝癌49例)的血清TBA、ALT,并与健康对照组比较。结果各种肝病患者的TBA、ALT均显著升高。急性肝炎、慢性活动性肝炎TBA与ALT升高显著,敏感性高,但肝硬化、肝癌两项指标阳性率结果差异明显(x^2=60.553,P<0.001):TBA阳性率高达90%以上,而ALT阳性率仅为20%左右。结论 TBA测定对于监测慢性肝病,尤其是肝硬化的早期诊断价值很大,是一项很具实用价值高敏感性的肝功能诊断指标。

Objective To investigate the clinical diagnosis of hepatopathy, serum total bile acid （TBA） measured the results ofclinical significance. Methods Hitachi 7600 fully automatic biochemical analyzer was applied to detect 272 cases ofhepatopathy （98 cases of acute hepatitis, chronic active hepatitis 54 cases, 71 cases of cirrhosis and liver cancer 49 cases） of serum TBA, ALT, and compared with the healthy control group. Results In patients with various hepatopathy TBA, ALT significantly increased. Acute hepatitis, chronic active hepatitis TBA and ALT are more sensitive, but cirrhosis, liver cancer two differences are significant indicators of results： TBA positive rate as high as 90% while that of ALT-positive rate was only about 20% （χ^2=60.553,P〈0.001. Conclusion TBA measurement for monitoring chronic liver disease, especially the early diagnosis of cirrhosis of great value, is a very high sensitivity with practical diagnostic index of liver function.