毒性弥漫性甲状腺肿伴肝细胞损害患者血清甘胆酸检测的临床意义

The Clinical Significance of Serum Cholic Acid Detection in Patients with Toxic Diffuse Goiter and Hepatocyte Damage

目的探讨毒性弥漫性甲状腺肿(Graves病)伴肝细胞损害患者血清甘胆酸检测的临床意义。方法选自我院于2012年9月至2017年9月期间收治的Graves病伴肝细胞损害患者31例作为观察组;另选自我院于2012年9月至2017年9月期间收治的单纯Craves病30例作为对照组。所有研究对象均于清晨空腹抽取外周静脉血,分离血清标本,采用全自动生化分析仪测定天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)、丙氨酸转氨酶(ALT)、胆碱酯酶(ChE)含量,血清甘胆酸(CG)含量。结果观察组血清AST、GGT和ALT含量高于对照组,而血清ChE低于对照组,差异具有统计学意义(P<0.05);观察组血清甘胆酸水平高于对照组,且有统计学差异(P <0. 05);Graves病伴肝细胞损害血清甘胆酸与AST、GGT和ALT呈线性正相关,而与ChE呈线性负相关。结论 Graves病伴肝细胞损害患者血清甘胆酸明显升高,且与肝功能存在明显相关性,可为Graves病伴肝细胞损害诊断提供依据。

Objective To explore the clinical significance of serum cholic acid detection in patients with toxic diffuse goiter （Graves disease） accompanied by hepatocyte damage. Methods From September 2012 to September 2017, 31 cases of Graves＇s disease with hepatocyte damage were selected as observation group, and 30 cases of Graves disease treated in our hospital from September 2012 to September 2017 were selected as control group. For all subjects, the early morning fasting venous blood were collected, then with the serum separation. The aspartate aminotransferase was determined by automatic biochemical analyzer （AST）, glutamyltranspeptidase （ GGT）, alanine aminotransferase （ ALT ）, and cholinesterase （ChE） content were also measured by using the homogeneous enzyme immunoassay for determination of serum cholylglycine content. Results The serum levels of AST, GGT and ALT in observation groupwere higher than the control group, while the serum ChE lower than the control group （ P 〈 0.05 ） ; serum glycocholic acid level in observation group was higher than the control group （ P 〈 0.05 ） ; serum glycocholic acid was positively correlated with AST, GGT and ALT with Graves＇ disease liver cell damage, and with a negative linear correlation with ChE. Conclusion Serumcholic acid is significantly increased in patients with Graves＇s disease and liver cell damage, and has significant correlation with liver function. It can provide evidence for diagnosis of Graves disease with hepatocellular damage.