肝硬化患者血浆钠和CA125水平变化的临床意义

Clinical significance of changes of plasma sodium and CA125 levels in patients with cirrhosis

目的肝硬化患者血浆钠水平的降低和糖类抗原125(CA125)水平的升高与肝硬化Chlid-Pugh分级、腹腔积液量的关系分析及其临床意义探讨。方法选择2016年6月—2019年9月本院感染科收治的肝硬化患者231例作为研究对象,根据肝硬化的Chlid-Pugh评分分级标准分为A级(n=110)、B级(n=72)、C级(n=49);根据肝硬化患者的腹腔积液量分为无腹腔积液组(n=107)、少量腹腔积液组(n=57)、中量腹腔积液组(n=34)、大量腹腔积液组(n=33)。同时测定其血浆钠和CA125水平,并根据血浆钠水平分为正常钠组(n=81)、轻度低钠组(n=58)、中度低钠组(n=46)、重度低钠组(n=46)。比较不同Chlid-Pugh分级、不同腹腔积液量中,血浆钠和CA125水平的变化,研究其与各组之间的相关性。结果血浆钠水平的降低、CA125水平的升高在不同Chlid-Pugh分级中,差异均有统计学意义(P<0.01)。血浆钠水平的降低、CA125水平的升高,腹腔积液组高于无腹腔积液组(P<0.05);中量腹腔积液组高于轻度腹腔积液组(P<0.01)。而大量腹腔积液组与中量腹腔积液组之间相比,差异无统计学意义(P>0.05)。血浆钠水平的降低和CA125水平的升高与Chlid-Pugh分级、腹腔积液量均相关(P<0.01)。结论血浆钠水平的降低和CA125水平的升高与Chlid-Pugh评分和腹腔积液量密切相关,可以用于评估判断肝功能损害程度,对于肝硬化病情的判断和预后有一定价值。

Objective To analyze the relationship between the decrease of plasma sodium level and the increase of CA125(carbohydrate antigen 125)level and the Chlid-Pugh grade and the volume of peritoneal effusion in patients with cirrhosis,and to explore their clinical significance.Methods A total of 231 patients with cirrhosis those admitted to the infection department of the first affiliated hospital of Bengbu Medical College from June 2016 to September 2019 were selected as the research subjects.According to the Chlid-Pugh grading standard the patients with liver cirrhosis were classified into A grade(n=110),B grade(n=72),and C grade(n=49).According to the volume of peritoneal effusion in cirrhosis patients,they were divided into three groups:no peritoneal effusion group(n=107),small amount of peritoneal effusion group(n=57),moderate amount of peritoneal effusion group(n=34),and large amount of peritoneal effusion group(n=33).The plasma sodium and CA125 levels were determined,and they were divided into normal sodium group(n=81),mild hyposodium group(n=58),moderate hyposodium group(n=46)and severe hyposodium group(n=46)according to the plasma sodium level.The changes of plasma sodium and CA125 levels in different Chlid-Pugh grades and different peritoneal effusion volumes were compared to study the correlation between them and each group.Results The decrease of plasma sodium level and the increase of plasma CA125 level were statistically significant among different Chlid-Pugh grades(P<0.01).The decrease of plasma sodium level and the increase of CA125 level in peritoneal effusion group were higher than those in non-peritoneal effusion group(P<0.05).The moderate peritoneal effusion group was higher than the mild peritoneal effusion group,and the differences were statistically significant(P<0.01).However,there was no significant difference between the large amount peritoneal effusion group and the moderate amount peritoneal effusion group(P>0.05).The decrease of plasma sodium level and the increase of CA125 level were correlated with Chlid-Pugh grade and the volume of abdominal effusion(P<0.01).Conclusions The decrease of plasma sodium level and the increase of CA125 level are closely related to the Chlid-Pugh score and the volume of peritoneal effusion,which could be used to evaluate the degree of liver function damage,and have certain value for the judgment and prognosis of cirrhosis.