肝硬化患者急性时相蛋白水平与Child-Pugh分级的相关性研究——附58例检测分析

Correlation between serum level of acute phase protein and Child-Pugh score in hepatic cirrhosis.An analysis of 58 cases

目的:分析无明显感染的肝硬化患者各种急性时相蛋白水平与Child-Pugh分级的关系及临床意义。方法:采用全自动速率散射比浊法对58例无明显感染的肝硬化患者和48例非肝硬化患者进行4种急性时相蛋白犤C-反应蛋白、α1-酸性糖蛋白、铜蓝蛋白和触珠蛋白犦的检测,并与Child-Pugh分级等指标行单因素直线相关及多元逐步回归分析。结果:与对照组比较,肝硬化患者的C-反应蛋白水平升高,α1-酸性糖蛋白、触珠蛋白水平明显下降。α1-酸性糖蛋白、触珠蛋白和铜蓝蛋白水平随Child-Pugh分级的增高而逐步下降,α1-酸性糖蛋白、触珠蛋白及铜蓝蛋白与Child-Pugh分级呈明显相关,相关系数r分别为:-0.42、-0.42和-0.37,均为P<0.05。4项急性时相蛋白与其他生化指标的相关检验结果:4项急性时相蛋白与白蛋白无相关,α1-酸性糖蛋白与总胆红素、凝血酶原时间相关,触珠蛋白与凝血酶原时间、载脂蛋白B相关,铜蓝蛋白与载脂蛋白A相关,多因素逐步回归分析显示Child-Pugh分级与α1-酸性糖蛋白、触珠蛋白密切相关。结论:肝硬化患者的C-反应蛋白水平升高,α1-酸性糖蛋白、触珠蛋白水平明显下降,铜蓝蛋白在肝损伤程度较轻时升高,肝损伤严重时呈下降趋势。在无明显继发感染的前提下,酒精性及肝炎后肝硬化患者α1-酸性糖蛋白。

Objective:To investigate the relationship between serum level of acute phase prote in(APP)and Child-Pugh score and its clinical significance.Methods :58cases of hepatic cirrhosis withou t complicated infection and 48contr ol subjects were enrolled.Serum levels of C-reactiv e protein(CRP),α 1 -acid glycoprotein(α 1 -AG),heptoglobin(HEP)and ceruloplasmin(CER)were measured on the second day of adm ission.Liver function tests and Chi ld-Pugh score were assessed.Correlation coefficiencies were derived by linear analysis.APP levels were correlated with Child-P ugh score and liver function tests by multiple regression anal-ysis.Results:CRP was higher in patients with cirrh osis than that in control subjects(P<0.05),whileα 1 -AG and HPT decreased in patients with cirrhosis(P<0.001,P<0.001).α 1 -AG,HEP and CER decreased in parallel wit h Child-Pugh score and correlated with Child-Pugh score with coefficiencies of -0.42?-0.42and -0.37respectively(P<0.05).APP did not correlate with serum level of Albumin,whileα 1 -AG was correlated with TBIL and PT,HEP with PT and ApoB,CER with ApoA.Multiple regression analysis showedα 1 -AG and HEP were independently corre lated with Child-Pugh score.Conclusion:CRP elevates whileα 1 -AG and HPT decrease in hepatic cirrhosis.C ER is higher in mild cases than that in control but decreases with worsenin g of the disease.α 1 -AG,HEP and CER correlate with Child-Pugh score in cirrhotic patients withou t complicated infection and are useful in assessing the severity of hepatic cirrhosis.