总胆汁酸和前清蛋白在肝炎及肝炎后肝硬化中的临床意义

Study on the Clinical Significance of Total Bile Acids and Prealbumin in Hepatitis and Liver Cirrhosis

目的 回顾性分析总胆汁酸（TBA）、前清蛋白（PA）在肝炎和肝炎后肝硬化诊断中的临床意义.方法 收集延安大学附属医院2013年7～12月感染病科住院并确诊的肝病患者97例为观察组,其中肝炎组53例,肝炎后肝硬化组44例.收集同期健康体检者50例作为对照组.三组分别进行TBA和PA检测,TBA采用循环酶法,PA采用免疫比浊法.结果 肝炎组TBA水平（15.20±20.22μg/L）和肝炎后肝硬化组TBA水平（39.40±34.09 μg/L）均高于对照组（3.15±2.37μg/L）,二者与对照组分别比较,差异具有统计学意义（q=3.89,11.11,P＜0.05）;肝炎后肝硬化组的TBA高于肝炎组,差异具有统计学意义（q=7.17,P＜0.05）.肝炎组PA水平（224.23±69.34 mg/L）和肝炎后肝硬化组PA水平（167.37±62.41 mg/L）均低于对照组（294.44±38.44 mg/L）,二者与对照组分别比较,差异具有统计学意义（q=8.69,15.03,P＜0.05）.肝炎后肝硬化组TBA,PA的阳性率（65.91％,77.27％）明显高于肝炎组（20.75％,39.6％）和对照组（2.00％,4.00％）的阳性率,差异均有统计学意义（P＜0.05）.肝炎组TBA,PA的阳性率明显高于对照组,差异有统计学意义（P＜0.05）.结论 TBA和PA水平直接反映肝脏功能减退与损伤程度,其阳性率可作为肝病诊断的重要指标.

Objective To retrospectively analysed clinical significance of total bile acids and prealbumin in hepatitis and posthepatitic cirrhosis. Methods Collected 97 definite patients with liver disease from July to December in 2013. Among them 53 cases were hepatitis patients,44 cases were posthepatitic cirrhosis patients. Meanwhile, collected 50 healthy serum as control group,TBA detection and PA detection were respectively carried on. Enzymatic cycling assay was used in PBA de- tection,immunoturbidimetry assay was used in PA detection. Results The value of TBA of hepatitis patients （15.20 ± 20.22 μg/L） and posthepatitic cirrhosis patients （39.40±34.09μg/L） were all higher than the control group （3.15±2.37 μg/L）. Separately were all compared with control group, the difference was statistically significant （q = 3.89,11.11, P〈 0.05）. The values of TBA of posthepatitie cirrhosis patients were all higherthan the hepatitis patients, the difference was statistically significant （q=7.17 ,P〈0.05）. The value of PA of hepatitis patients （224.23±69.34 mg/L） and posthepatitic cirrhosis patients （167.37±62.41 mg/L） were all lower than the control group （294.44±38.44 mg/L）. Separately were all compared with control group, the difference was statistically significant （q = 8.69,15.03, P〈 0.05 ）. The positive rate of TBA and PA of hepatitis patients was obviously higher than the control group, and the difference was statistically significant （P〈0.05）. Conclusion The value of TBA and PA was a direct reflection of the degree of injury of liver function. Its posi- tive rate can be regarded as an important indicator of liver disease diagnosis.