肝病患者血生化及凝血酶原时间检测的临床意义

The significance of the biochemistry and prothrombin time in patients with liver disease

目的:探讨总胆汁酸(TBA)、胆碱酯酶(CHE)、白蛋白(ALB)、前白蛋白(PAB)、谷丙转氨酶(ALT)以及凝血酶原时间(PT)对各种肝病患者的诊断价值。方法:检测648例各类肝病患者及134例正常人的TBA、CHE、ALB、PAB、ALT和PT。结果:TBA、CHE、PAB、ALT和PT在急性黄疸肝炎、慢性肝炎、肝炎后肝硬化、肝癌组和正常对照组均有明显区别,而ALB在急性黄疸性肝炎患者和正常对照组无明显差别;急性黄疸性肝炎中ALT灵敏度最高,ALB灵敏度最低,肝炎后肝硬化中PAB灵敏度最高,慢性重度肝炎中,除ALT外,其余五项指标灵敏度均为100%;随着肝炎后肝硬化和重型肝炎的好转,TBA、ALT、PT会有一定程度的降低,CHE、ALB、PAB会有一定程度的升高,其中TBA、CHE、PAB、ALT、PT的改变均有统计学意义。结论:联合检测TBA、CHE、ALB、PAB、ALT及PT对肝病患者的临床诊断、病情判断及预后有一定参考价值。

Objective：To discuss the diagnostic value of the examination of serum TBA,CHE,ALB,PAB,ALT,PT in the patients suffering from liver diseases.Methods： TBA,CHE,ALB,PAB,ALT and PT were examined with auto biochemical analyzer and STAGO active hemagglutination apparatus in 648 hepatitis cases and 134 healthy cases.Results： The mean values of TBA,CHE,PAB,ALT,PT in acute hepatitis patients,chronic hepatitis patients,liver cirrhosis patients and liver cancer were significantly higher than those of healthy cases.Sensitivity of ALT is highest and sensitivity of ALB is lowest in acute icterohepatitis.Sensitivity of PAB is highest in posthepatitic cirnhosis.The sensitivity of five index were 100% except ALT in chronic heavy hepatitis.Along with posthepatitic cirrhosis and heavy hepatitis improving,the value of TBA,ALT and PT were lower and the CHE,ALB and PAB were heighten.Conclusion： It is valuable to associate measure TBA,CHE,ALB,PAB,ALT and PT in the hepatopath clinical diagnosis,patient′s condition judgement and prognosis.