血清前白蛋白、总胆汁酸、AST/ALT比值在肝硬化分级中的诊断意义

Diagnostic significance of prealbumin,total bile acid and AST/ALT ratio in cirrhosis classification

目的探讨肝硬化患者血清前白蛋白(PA)、总胆汁酸(TBA)、(天)门冬氨酸氨基转移酶(AST)/丙氨酸氨基转移酶(ALT)与肝硬化Child-Pugh分级的关系。方法测定肝硬化患者的PA、TBA、AST和ALT水平。结果血清PA在肝硬化A、B、C级之间比较明显降低;血清白蛋白在肝硬化患者中降低,A级与B、C级之间差异有统计学意义,而B、C级之间差异无统计学意义;TBA在肝硬化A、B、C级之间升高,但A、B级间比较差异无统计学意义,在B、C级之间差异有统计学意义;AST/ALT比值升高,A、B、C级之间比较,差异有统计学意义。结论 PA、TBA、AST/ALT比值对判断肝硬化程度具有重要的指导意义,可作为肝硬化患者病情诊断和预后判断的重要指标。

Objective To investigate the relationship between the three indicators （PA, TBA and ALT/AST） and Child-Pugh classification in patients with cirrhosis. Methods The three indicators （PA, TBA and ALT/AST ） were determined and analyzed. Results The PA reduced obviously along with the levels increasing, with significant difference between each level; ALB also reduced in cirrhosis, with significant difference between the level A and level B or C, while no statistical difference between B and C ; TBA increased along with the level increasing, with no statistically significant difference between level A and B but between B and C; ALT/AST ratio gradually rose from level A to B with significant difference between each levle. Conclusion The three indicators （PA, TBA and ALT/ AST） are important for the diagnosis and prognosis of cirrhosis.