原发性肝癌患者血清转铁蛋白、前白蛋白和总胆汁酸与肝脏储备功能的关系

Study on the Relationship between the Levels of Serum Transferrin, Prealbumin and Total Bile Acids and the Hepatic Reserve Function in Primary Liver Cancer Patients

目的检测和比较不同肝储备功能状况的原发性肝癌(PHC)患者的血清转铁蛋白(TRF)、前白蛋白(PAB)和总胆汁酸(TBA)水平,探讨它们与肝脏储备功能的关系以及三者联合检测在PHC病情诊断中的意义。方法 2010年3月-2013年2月期间收集PHC患者164例,根据Child-Pugh分级标准,依据肝损伤程度不同分为Child-Pugh A、B、C 3组,分别为67、55、42例;另选择58例健康体检者为对照组。分别采用化学发光免疫分析法、免疫透射比浊法和酶循环法测定血清TRF、PAB及TBA水平并进行组间比较。结果对照组及Child-Pugh A、B、C级组血清TRF分别为(2.574±0.214)、(1.618±0.135)、(0.988±0.121)、(0.314±0.107)g/L,各组间差异均有统计学意义(P<0.05);对照组及Child-Pugh A、B、C级组血清PAB分别为(269.32±37.29)、(165.22±21.01)、(123.24±31.15)、(83.66±19.74)mg/L,各组间差异均有统计学意义(P<0.05);对照组及Child-Pugh A、B、C级组血清TBA水平分别为(9.16±2.48)、(65.13±4.25)、(133.62±8.44)、(250.73±21.59)μmol/L,各组间差异均有统计学意义(P<0.05)。TRF水平与PAB呈正相关(r=0.927,P<0.001),TRF和PAB水平均与TBA水平呈负相关(r=-0.454,P<0.001;r=-0.432,P<0.001)。结论血清TRF、PAB和TBA水平与肝储备功能密切相关,可以作为鉴定PHC患者肝脏储备功能的重要指标,联合检测三者对PHC的病情诊断具有重要意义。

Objective To explore the relationship between the levels of transferrin（TRF）, prealbumin（PAB） and total bile acids（TBA） in serum and the loss of the hepatic reserve function in primary liver cancer（PHC） patients and the importance of the former factors for diagnosis of PHC. Methods A total of 154 patients with PHC collected between March 2010 and February 2013 were included in our study. Based on the information of hepatic reserve function and the Child-Pugh classifi cation standard, the patients were divided into Child-Pugh-A, B, and C groups with 67, 55 and 42 patients respectively. Another 58 healthy subjects were selected as the control group. Serum TRF, PAB and TBA levels were measured by automated chemiluminescence immunoassay, immune turbidimetric assay and enzymatic cycling respectively, and they were compared among the groups. Results TRF level of patients in the control group and Child-Pugh-A, B, and C groups was respectively（2.574 ± 0.214）,（1.618 ± 0.135）,（0.988 ± 0.121）, and（0.314 ± 0.107） g/L, with signifi cant differences among the groups（P 〈0.05）. PAB level of patients in four groups was respectively（269.32 ± 37.29）,（165.22 ± 21.01）,（123.24 ± 31.15）, and（83.66 ± 19.74） mg/L, with signifi cant differences among the groups（P 〈0.05）. TBA level in the above four groups was respectively（9.16 ± 2.48）,（65.13 ± 4.25）,（133.62 ± 8.44）, and（250.73 ± 21.59） μmol/L, and there was also signifi cant differences among the groups. A positive correlation between serum TRF and PAB was found（r=0.927, P〈0.001）, and negative correlations between serum TBA level and serum TRF and between TBA and PAB were found（r=-0.454, P 〈0.001; r=-0.432, P〈 0.001, respectively）. Conclusion Serum TRF, PAB and TBA levels are closely related to the hepatic reserve function in PHC patients, and they can be used as an important indicator for PHC diagnosis.