血清胆碱酯酶测定对临床预后价值探讨

Determination of Serum Cholinesterase to Investigate the Value of Clinical Prognostic

目的探讨血清胆碱酯酶变化与临床预后之间相关性。方法分析2009-12～2014-12住院死亡1099例,资料完整884例,分肿瘤与非肿瘤组,按系统分析患者死亡前3周及1周血清胆碱酯酶与肝功能变化数值,进行统计学处理,P〈0.05为差异显著。结果全部死亡病例胆碱酯酶下降明显（P〈0.05）,尤其是乳腺癌患者（P〈0.001）.胆碱酯酶升高46例,占5.2%。全部死亡病例除食管、胃癌及血液骨髓肿瘤,、外伤及泌尿生殖系统疾病谷丙转氨酶变化不明显（P〉0.05）,余均差异显著（P〈0.05）。192例肝功能正常,占23.8%。结论血清胆碱酯酶持续下降,特别是下降幅度大于30%,提示预后不良。血清胆碱酯酶测定可作为临床病情监测与判断预后的一种指标,值得推广应用及进一步研究。其下降机制可能与肝肾功能受损、炎症反应及机体主动调节有关。胆碱酯酶升高机制不明,需进一步探讨。

Objective To investigate the correlation between changes in serum cholinesterase and clinical prognosis. Methods A retrospective analysis of hospital inpatient 2009. 12 ～ 2014. 12 1099 cases of deaths,884 cases with complete data,divided between tumor and non- tumor group,serum cholinesterase and liver function numerical analysis by the system statistics before the patient died one week,three weeks,P〈0. 05 was considered significant. Results All of deaths cholinesterase decreased significantly（ P〈0. 05）,especially in patients with breast cancer（ P〈0. 001）. Cholinesterase increased 46 cases,accounting for 5. 2% of all deaths in addition to the esophagus,stomach and blood marrow,trauma and genitourinary system diseases alanine aminotransferase did not change significantly（ P〈0. 05）,the others were significantly different（ P〈0. 05）. 192 patients with normal liver function, accounting for 23. 8%.Conclusions The serum cholinesterase continued to decline,in particular,declined more than 30%,suggesting a poor prognosis. Determination of serum cholinesterase can be used as an indicator to determine the clinical disease surveillance and prognosis determined,and further research and widely applied should be done in the future. The mechanism may be related the decline in liver and renal function,inflammation and active regulation of the body. Cholinesterase elevated mechanism is unknown,should be further explored.