空腹血清总胆汁酸对肝硬化患者肝功能的评价

Evaluation of fasting serum total bile acid to the hepatic functions of the patients with liver cirrhosis

目的 观察空腹血清总胆汁酸 (sTBA)对肝硬化患者肝功能的评价作用。方法 采用Child pugh计分法对临床诊断为肝硬化的 10 3例病人分为Child pughA级 (4 1例 )、B级 (4 4例 )和C级 (18例 )。所有病人取空腹血 ,酶免法测sTBA ,比较不同Child pugh分级肝硬化病人sTBA水平。同时测定所有病人血清中丙氨酸转氨酶 (ALT) ,并作对比分析。结果 肝硬化患者sTBA水平明显高于非肝病对照组 (5 4 8± 3 7 5 μmol/LVS 12 6± 9 1μmol/L ,P <0 0 5 ) ;且不同child pugh分级肝硬化病人sTBA亦相差显著 ,肝功能分级越差的病人 ,其sTBA越高。除Child pughC级血清ALT与其它两组相差显著外 (P <0 0 5 ) ,Child pughA级与B级间无显著差异 (P >0 0 5 )。结论 空腹sTBA不但是区分肝脏病与非肝脏病的良好生化指标 ,同时也是反映肝硬化肝功能状态的良好指标之一。

Aim To observe the role of the fastings serum total bile acid (sTBA) in evaluating the hepatic functions of patients with liver cirrhosis. Methods one hundred and three patients with liver cirrhosis were divided into three groups∶Child pugh A(41),Child pugh B(44) Child pugh C(18) according to Child pugh score classification. Twenty one patients without liver disease as the controls. Fasting serum total bile acid and serum alanine aminotransferase (ALT) was tested through the enzymatic colorimetric method in all the patients, and the concentration of TBA and ALT was analyzed respectively. Results The concentration of fasting serum total bile acid in patients with liver cirrhosis was higher significantly than that in control group(54.8±37.5 μmol/L VS 12.6±9.1 μmol/L, P <0 05). further more the increase of serum ALT was observed and there was significant difference between child C and child A?child B ( P <0 05), while no significant difference between Child A and B group (P>0 05). Conclusions Fasting serum total bile acid is a sensitive biochemical parameter not only in the discriminating liver disease from non liver disease, but also in evaluating hepatic functions of cirrhotic patients.