胆红素与氨基转移酶水平对原发性胃癌患者外科治疗后生存状况的影响

Effects of bilirubin and aminotransferase levels on the survival of patients with primary gastric cancer after surgical treatment

目的:探讨胆红素与氨基转移酶水平对原发性胃癌患者外科治疗后生存状况的影响。方法:选择2013年1月至2015年12月在我院就诊的胃癌患者312例为研究对象,116例死亡患者作为死亡组,196例存活患者作为存活组,入院时对两组患者采用重氮法测定胆红素水平,采用速率法测定氨基转移酶水平。结果:死亡组患者总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)水平[(21. 04±4. 02)μmol/L、(5. 30±1. 03)μmol/L、(16. 38±1. 44)μmol/L]均显著高于存活组患者[(14. 39±4. 95)μmol/L、(3. 55±1. 04)μmol/L、10. 20±3. 58)μmol/L],差异有统计学意义(P <0. 05);死亡组患者天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平[(69. 38±14. 56) U/L、(113. 85±14. 73) U/L]均显著高于存活组[(21. 84±10. 83) U/L、(24. 59±10. 34) U/L],差异有统计学意义(P <0. 05)。死亡组患者临床分期多为Ⅱ、Ⅲ期,浸润深度多为T3、T4,淋巴结转移率和远处转移率显著高于存活组,差异有统计学意义(P <0. 05)。Logistic回归分析显示,DBIL、AST水平均是影响胃癌患者治疗后生存状况的独立危险因素(P <0. 05)。结论:DBIL、AST水平与胃癌患者生存状况呈负相关,且DBIL、AST水平升高是影响胃癌患者治疗后生存状况的独立危险因素。

Objective:To investigate the effects of bilirubin and aminotransferase levels on the survival of patients with primary gastric cancer after surgical treatment.Methods:A total of 312 patients with gastric cancer were enrolled in our hospital from January 2013 to December 2015.116 patients died as the death group and 196 survivors as survival group.Diazo the bilirubin level was measured by the method and the aminotransferase level was measured by the rate method.Results:The levels of TBIL,DBIL,and IBIL in the death group[(21.04±4.02)μmol/L,(5.30±1.03)μmol/L,(16.38±1.44)μmol/L]were significantly higher than those in the survival group[(14.39±4.95)μmol/L,(3.55±1.04)μmol/L,(10.20±3.58)μmol/L],with statistically significant differences(P<0.05),AST and ALT levels in the death group[(69.38±14.56)U/L,(113.85±14.73)U/L]were significantly higher than those in the survival group[(21.84±10.83)U/L,(24.59±10.34)U/L],with statistically significant differences(P<0.05).Most of the clinical stages were stageⅡandⅢ.The infiltration depth was mostly T3 and T4.The lymph node metastasis rate and distant metastasis rate were significantly higher than those in the survival group.The statistical difference was significant(P<0.05).Logistic regression showed that DBIL and AST levels were independent risk factors for survival after treatment in gastric cancer patients(P<0.05).Conclusion:The levels of DBIL and AST are negatively correlated with the survival of patients with gastric cancer.The elevated DBIL and AST levels are independent risk factors for the survival of patients with gastric cancer after treatment.