CG、TBA联合检测与传统肝损伤酶活性指标检测在肝胆疾病诊断中的价值对比研究

目的 探讨血清甘胆酸(Cholyglycine,CG)与总胆汁酸(total bile acid,TBA)联合检测与传统肝损伤酶活性指标检测在肝胆疾病诊断中的价值对比。方法 选取2021年1月至2021年12月我院收治的100例肝胆疾病患者,其中肝炎39例(甲组),肝硬化17例(乙组),肝癌21例(丙组),胆道疾病23例(丁组),同时期在我院体检的50例健康者为对照组,均给予CG、TBA联合检测与传统肝损伤酶活性指标检测,比较检测结果。结果 (1)与对照组相比,肝胆疾病患者CG、TBA与传统肝损伤酶活性指标显著增高(P<0.05);(2)在肝胆疾病患者中,CG、TBA联合检测阳性率高于传统肝损伤酶活性指标检测(P<0.05)。CG、TBA联合检测阳性率高于传统肝损伤酶活性指标检测(P<0.05);(3)CG、TBA联合检测敏感度、准确度均高于传统肝损伤酶活性指标检测(P<0.05),两种检测方式特异度比较(P>0.05)。结论 与传统肝损伤酶活性指标检测相比,CG、TBA联合检测对于肝胆疾病具有更高的诊断价值。

苦黄注射液与亮菌甲素治疗急性黄疸性肝炎患者的效果对比

目的:对比苦黄注射液与亮菌甲素治疗急性黄疸性肝炎患者的效果。方法:选取2019年1月—2022年1月镇江市第三人民医院收治的102例急性黄疸性肝炎患者作为研究对象,采用随机数表法分为研究组(亮菌甲素,51例)和对照组(苦黄注射液,51例)。比较两组治疗前后肝功能指标[天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、血清总胆红素]、血常规[白细胞(WBC)、血小板(PLT)]、血清学肝损伤指标[白细胞介素-18(IL-18)、一氧化氮(NO)]及治疗期间不良反应(乏力、干呕、恶心、呕吐)发生情况。结果:治疗前,两组肝功能指标、血清学肝损伤指标比较,差异均无统计学意义(P>0.05);治疗后,两组AST、ALT、总胆红素、NO、IL-18较治疗前均降低,且研究组均低于对照组,差异均有统计学意义(P<0.05)。两组治疗前后WBC、PLT比较,差异均无统计学意义(P>0.05)。研究组不良反应发生率低于对照组,差异有统计学意义(χ^(2)=3.991,P=0.046)。结论:与苦黄注射液相比,亮菌甲素治疗急性黄疸性肝炎患者可有效改善肝功能及血清学肝损伤指标,降低不良反应发生率。

HBV感染者血清转氨酶与胆碱脂酶、前白蛋白、白蛋白的关系研究

目的 研究HBV感染者血清转氨酶与白蛋白、前白蛋白、胆碱酯酶的关系.方法 对2013年11月~2015年11月间在本院就诊或体检的HBV感染者98例进行研究,以ALT/AST为依据进行分组,45例正常为观察A组,25例轻度异常为观察B组,28例异常为观察C组,以CHE水平为依据进行分组,46例正常为观察1组,23例轻度异常为观察2组,29例异常为观察3组,对各指标相互关系进行分析.结果 观察A组的ALB、PA、CHE明显高于观察B组与观察C组,观察B组的PA高于观察C组;观察1组的PA、ALB高于其他两组,观察2组PA、ALB大于观察3组,P<0.05,差异有统计学意义.结论 肝损伤与肝功能指标相关密切,应综合两类指标进行评价,提升对HBV感染者诊断的全面性.

Correlation of serum arylesterase activity on phenylacetate estimated by the integrated method to common classical biochemical indexes of liver damage

The correlation of serum arylesterase(PON1) activity on phenylacetate determined by an integrated method to clas-sical biochemical indexes of liver damage was investigated for the use of PON1 activity to evaluate liver damage.PON1 reaction curve as absorbance at 270 nm for 0.20 mmol/L phenylacetate hydrolysis was analyzed by the integrated method to determine maximal PON1 reaction rate.Classical biochemical indexes of liver damage were determined routinely.The 95% confidence threshold of PON1 activity in sera from healthy individuals was 2.12 mkat/L [(4.73±1.31) mkat/L,n=105].PON1 activity in clinical sera was closely correlated to serum albumin,total protein and the ratio of albumin to globulins,but was weakly correlated to both direct and total bilirubin in serum.There were no correlations of PON1 activity to γ-glutamyltransferase,alkaline phos-phatase,alanine aminotransferase and aspartate aminotransferase.Among 127 clinical sera with PON1 activity>2.12 mkat/L,there were 92% healthy individuals examined by albumin,90% healthy individuals examined by total protein,88% healthy individuals examined by total bilirubin,86% healthy individuals examined by direct bilirubin and 64% healthy individuals examined by the ratio of albumin to globulins,respectively.In each group of healthy individuals judged by classical biochemical indexes of close correlation to PON1 activity,percentage of healthy individuals examined by PON1 activity was always >80%.These results suggested PON1 activity on phenylacetate estimated by the integrated method was also suitable for the evaluation of liver damage.