四项生化指标检验在肝硬化和病毒性肝炎中的价值

Clinical Value of Combined Detection of Four Biochemistry Indexes in Liver Cirrhosis and Viral Hepatitis

目的 探讨血清胆碱酯酶（ChE）、清蛋白（ALB）、胆汁酸（TBA）和总胆红素（TBIL）联合检测在肝硬化和病毒性肝炎中的临床意义.方法 选取2012年3月～6月来淮北市人民医院就诊的肝硬化患者40例、病毒性肝炎患者44例及健康对照者41例为研究对象,应用比色法和循环酶速率法分别检测血清中ChE,ALB,TBIL和TBA水平,同时对测定结果进行比较分析.结果 肝硬化组、病毒性肝炎组和对照组血清ChE,ALB,TBA和TBIL值分别为3 015±824 U/L,26.1±5.7 g/L,61.4±58.4 μmol/L和75.2±91.2 μmol/L;6 673±2 194 U/L,36.7±4.1 g/L,18.9±19.6 μmol/L和20.1±15.7 μmol/L;8 599±1 435 U/L,45.0±1.8 g/L,12.0±2.6 μmol/L和10.8±6.5 μmol/L.三组人群ChE,ALB,TBA和TBIL各浓度总体差异均有统计学意义（F=17.8～209.6,P值均〈0.01）.肝硬化组与病毒性肝炎组和对照组比较,ChE和ALB水平均明显降低,TBA和TBIL水平则显著升高,差异有统计学意义（P〈0.01）.而病毒性肝炎组与健康对照组比较,ChE和ALB水平较低（P〈0.01）,TBA和TBIL的检测结果则无差异（P〉0.05）.并且,肝硬化组ChE,ALB,TBA和TBIL阳性率（分别为85.0%,95.0%,90.0%和90.0%）也远高于病毒性肝炎组（分别为6.8%,25.0%,38.6%和36.4%）,差异有统计学显著性意义（χ2=23.74～51.96,P值均〈0.01）.结论 血清中ChE,ALB,TBA和TBIL浓度变化与肝实质损害程度密切相关,联合检测可作为诊断、鉴别诊断肝硬化的辅助依据.

Objective To explore the clinical significance of combined detection of serum choline esterase（ChE）, albumin （ALB）,bile acid（TBA） and total bilirubin levels（TBIL） in liver cirrhosis and viral hepatitis. Methods The sera samples were collected from 40 patients with liver cirrhosis, 44 patients with viral hepatitis and 41 healthy controls from March 2012 to June 2012 in Huaibei People＇s Hospital. The levels of serum ChE,ALB,TBIL and TBA of them were detected with color- imetric method or circulation enzyme rate method. Then the comparative analysis was performed. Results The concentra- tions of ChE, ALB,TBA and TBIL in liver cirrhosis group,viral hepatitis group and healthy controls group were separately 3 015±824 U/L,26.1±5.7 g/L,61.4±58.4 μmol/L,75.2±91.2 μmol/L;6 673±2 194 U/L,36.7±4. 1 μg/L,18.9± 19.6 μmol/L,20. 1±15.7 μmol/L;8 599±1 435 U/L,45.0±1.8 g/L,12.0±2.6 μmol/L,10.8±6.5 μmol/L. There were sig- nificant differences of the levels in liver cirrhosis group,viral hepatitis group and healthy controls group （F= 17.8~209.6, P〈0.01）. Comparing liver cirrhosis group with viral hepatitis group and healthy controls group,the choline esterase and al- bumin levels were significantly lower, the TBA and TBIL levels were remarkably higher, there were significant difference （P d0. 01）. Comparing viral hepatitis group with healthy controls group, the ChE and ALB were lower （P〈0.01）, but the re- sults of TBA and TBIL were not different between them （P〉0.05）. And, the positive rates （85.0%,95.0%, 90.0%, 90. 0%） of ChE, ALB, TBA and ATBA in liver cirrhosis group were very higher than those （6.80/00,25.0%,38. 6%, 36.4%） in viral hepatitis group too,the differences had statistic significance （x2= 23.74~51.96, P〈0. 01）. Conclusion The levels of serum ChE, ALB,TBA and TBIL were closely correlated with the liver injury. Combined detection are valuable to diagnosis and differential diagnosis of liver cirrhosis.