肝硬化患者血清CA19-9水平升高的原因探讨

Investigation of the cause of elevated serum CA19-9 levels in patients with liver cirrhosis

目的 研究肝硬化患者血清CA19-9水平与肝功能指标的关系 ,探讨肝硬化患者血清CA19-9升高的原因。方法 以肝硬化患者 5 3例为病例组 ,其中乙肝后肝硬化 46例、丙肝后肝硬化 3例、酒精性肝硬化 3例、原发性胆汁性肝硬化 1例。另以正常成人 40例作为对照组 ,均抽取静脉血检查生化肝功、CA19-9。结果 病例组血清CA19-9高于对照组。肝硬化患者血清CA19-9与丙氨酸转移酶 (ALT)、谷氨酰转肽酶 (γ -GT)、胆汁酸 (TBA)、天冬氨酸转移酶 (AST)、直接胆红素 (DBIL)存在正相关性 ,与血清白蛋白 (ALB)、碱性磷酸酶 (ALP)、总胆红素(TBIL)、间接胆红素 (IBIL)、前白蛋白 (PAB)及child -pugh评分无相关性。结论 在已除外并发恶性肿瘤的情况下 ,胆汁淤积是造成肝硬化患者血清CA19-9水平升高的主要原因。

Objective This study was to investigate the relation between serum CA19-9 levels and the biochemical parameters of liver function , and explore the cause of increasing serum CA19-9 levels in patients with liver cirrhosis. Methods The study group was consisted of 53 patients with liver cirrhosis , which included 46 patients of hepetitic B virus cirrhosis , 3 patients of hepetitic C virus cirrhosis , 3 patients of alcoholic cirrhosis and one patient of primary biliary cirrhosis. Forty normal adults were served as the control group. Their biochemical parameters of each function and serum CA19-9 level of every patient in both groups was examined at the same time. Results The serum CA19-9 level of the study group was higher than that of the control. The serum CA19-9 levels in patients with liver cirrhosis was positively correlated with alanine aminotransferase(ALT),γ-glutamyl(γ-GT), aspartate aminotranserase(AST),indirect bilirubin(IBIL)but not with albumin(ALB),alkaline phosphatase(ALP),total bilirubin(TBIL),direct bilirubin(DBIL), prealbumin(PAB), Child-Pugh's score. Conclusion Cholestasis is the main determinant of increasing serum CA 19-9 level in patients with liver cirrhosis on condition that the carcinoma does not exist.