胆碱酯酶、凝血酶原活动度及白蛋白与肝组织病理损害关系的研究

Relationship between cholinesterase, prothrombin activity and albumin and the pathology of the liver

目的 研究血清胆碱酯酶、白蛋白及血浆凝血酶原活动度与病毒性肝炎肝组织病理损害的关系。方法 采用酶速率法 ,测定 135例经病理证实的慢性肝炎、肝炎肝硬化及重型肝炎患者的血清胆碱酯酶活动力及白蛋白 ,同时采用比浊法测定他们的血浆凝血酶原活动度。结果 在慢性肝炎轻度至中度 ,血清胆碱酯酶活力较白蛋白及血浆凝血酶原活动度下降的百分率更高 ,差异有非常显著性意义 ,P均 <0 0 1;随着肝组织炎症程度的加重 ,各项指标均逐渐下降 ,差异有非常显著性意义 ,P均 <0 0 0 1;随着肝组织纤维化程度的加重 ,各项指标均逐渐下降 ,差异有非常显著性意义 ,P均 <0 0 0 1;血清胆碱酯酶活力、白蛋白及血浆凝血酶原活动度彼此间相关系数为 0 72 0～ 0 778(P均 <0 0 0 1)。结论 血清胆碱酯酶活力较白蛋白及血浆凝血酶原活动度能更好地反映肝脏的合成功能和储备功能 ,能更准确地反映肝脏的病理损害程度 。

Objective To investigate the relationship between serum cholinesterase, albumin and plasma prothrombin activity and the pathology of the liver in patients with viral hepatitis.Methods Totally 135 patients diagnosed as chronic hepatitis,cirrhosis and/or severe hepatitis with needle hiopsy of liver were enrolled in this study. Serum cholinesterase and albumin of the patients were detected with enzyme rate method; meanwhile, their plasma prothrombin activity was detected with turbidimetry test. Results The percentage of decrease of the level of serum cholinesterase was higher than that of albumin and plasma prothrombin activity in chronic mild and moderate hepatitis; the level of serum cholinesterase, albumin and plasma prothrombin activity decreased gradually followed by the exacerbation of inflammatory reaction ( P <0 001) and by the elevation of degree of fibrosis of the liver (\%P\%<0 001);their correlation coeficient was 0 720 to 0 778 ( P <0 001).Conclusion The level of serum cholinesterase could better and more sensitively reflect the synthetic function and the damage of the pathology of the liver than that of albumin and plasma prothrombin activity could do, they all negatively correlated with the pathology of the liver.