胆汁酸结合Child-Pugh分级对肝硬化患者肝功能的评价  

Serum total bile acid combined with Child-Pugh classification for evaluation of liver function in patients with liver cirrhosis

作　　者：高文[1] 康玮玮[1] 王小琪[1] 钟蕊[1] 王冬梅[1] 马洪波[1] 马列清[1] 

机构地区：[1]首都医科大学附属北京佑安医院肝肾科,北京100069

出　　处：《临床检验杂志（电子版）》2014年第2期622-624,共3页Clinical Laboratory Journal(Electronic Edition)

摘　　要：目的明确血清胆汁酸评价肝硬化肝脏功能的临床意义。方法回顾性分析我院肝硬化患者150例,并随访1年,计算Child-Pugh分级,将血清胆汁酸(total bile acid,TBA)与Child-Pugh分级对肝脏功能评价作用相比较,采用Logistic回归统计分析进行肝硬化患者1年生存状况评价,随机选取健康对照组100例。结果 150肝硬化病例中Child-Pugh A组30例,B组49例,C组71例。健康对照组与Child-PughA、B、C各组血清TBA值分别为4.5 mg/L±3.7mg/L,30.6 mg/L±8.7 mg/L,35.7 mg/L±6.9 mg/L,40.2 mg/L±11.1 mg/L,健康对照组与Child-Pugh各组血清TBA值比较具有显著性差异(P<0.05),血清TBA值在Child-Pugh A、B、C各组间比较也有显著性差异(P<0.05)。血清TBA结合Child-Pugh分级与单纯Child-Pugh分级相比较,Child-Pugh A组中20例手术病例,14例术前血清TBA在24.0 mg/L±6.1mg/L水平者术后未出现腹水,6例术前血清TBA为33.1 mg/L±6.4 mg/L水平者术后出现腹水(P<0.05)。结论血清TBA结合Child-Pugh分级的使用可反映肝功能损伤程度,利于预测肝病患者术后腹水发生的可能性。Objective To evaluate the clinical value of serum total bile acid(TBA) in patients with liver cirrhosis. Methods One hundred and fifty patients diagnosed with cirrhosis at our hospital were retrospectively analyzed and followed for 1 year. Each patient's Child-Pugh classification was calculated. Child-Pugh classification was compared with serum TBA combined with Child-Pugh classification in evaluating liver function. Logistic regression analysis was used to evaluate survival at 1 year in patients with liver cirrhosis. One hundred healthy subjects selected as control group. Results The patients were divided into three groups according to Child-Pugh classification: 30 patients in Child A group, 49 in Child B, and 71 in Child C. In the control group, Child A, Child B and Child C groups, serum TBA levels were 4.5±3.7, 30.6±8.7, 35.7±6.9 and 40.2±11.1 mg/L, respectively, which had statistical differences among the four groups(P<0.05 for all). Of 20 postoperative patients in the Child A group, the mean preoperative serum TBA in 14 patients without peritoneal dropsy was 24.0 mg/L±6.1 mg/L, and the value in 6 patients with peritoneal dropsy was 33.1 mg/L±6.4 mg/L(P<0.05). Conclusions Serum TBA combined with Child-Pugh classification can predict peritoneal dropsy more efficiently.

关 键 词：胆汁酸 CHILD-PUGH分级 肝功能 

分 类 号：R575.2[医药卫生—消化系统]