血清前白蛋白、胆碱酯酶、凝血酶原活动度水平联合Child-Pugh分级对肝硬化患者预后的判断

The value of serum prealbumin,cholinesterase,prothrombin activity levels combined with Child-Pugh classification for the judgment of prognosis in patients with hepatic cirrhosis

[目的]探讨血清前白蛋白(PA)、胆碱酯酶(CHE)、凝血酶原活动度(PTA)联合Child-Pugh分级在判断肝硬化患者预后的意义。[方法]将肝硬化组125例患者根据Child-Pugh分级分为3个亚组:Child A级组(50例)、Child B级组(45例)及Child C级组(30例),选取健康体检者40例作为对照组。对所有入选者取静脉血测定血清PA、CHE及PTA水平,并进行腹部彩超检查了解肝、脾、门静脉宽度及腹水情况。[结果]肝硬化组血清PA、CHE及PTA水平均显著低于对照组(P<0.01);随着患者肝硬化程度加重,其血清PA、CHE及PTA水平逐渐降低,不同Child-Pugh分级组间比较差异均具有统计学意义(P<0.01);肝硬化组中存活患者PA、CHE及PTA水平均明显高于死亡者,差异均具有统计学意义(P<0.01)。[结论]肝硬化患者血清PA、CHE、PTA水平与肝功能Child-Pugh分级及预后相关,这些指标的联合对判断肝病损害严重程度及预测患者预后具有较大的临床价值。

[Objective] To investigate the use of serum prealbumin （PA）, cholinesterase （CHE）, prothrombin activity（PTA）combined with Child-Pugh classification for the judgment of prognosis in patients with hepatic cirrhosis. [Methods]The totals of 125 cirrhotic patients were divided into group Child A（50 cases） ,Child B（45 cases）and Child C（30 cases）according to Child-Pugh classification,and 40 cases of healthy persons were selected as the control group. Blood was taken for detecting the levels of serum PA,CHE and PTA,Abdominal sonography was performed to examine the liver, spleen,portal vein＇s width and ascites. [Results]The levels of serum PA,CHE and PTA in patients with liver cirrhosis were significantly lower than those in the control group（P〈0.01）. With the aggravation of liver cirrhosis,the levels of serum PA, CHE and PTA decreased gradually,and there were significant difference between the 3 groups（P〈0.01）. The levels of PA,CHE and PTA were significantly higher in the survival group than in the death group（P 〈0.01）. [Conclusion]The levels of serum PA, CHE and PTA in cirrhotic patients were correlated with Child-Pugh grading and prognosis,the combination of these indexes has great clinical value in judging the severity of liver damage and predicting the prognosis of patients.