胆汁内胆红素对移植肝脏早期功能预示价值的分析  

Value of analysis of bilirubin in bile in predicting liver function in early stage after liver transplantation

作　　者：陈立[1] 彭林[1] 郑虹[2] 王健[2] 高强[1] 沈中阳[2] 

机构地区：[1]天津市第一中心医院检验科,300192 [2]天津市第一中心医院移植外科,300192

出　　处：《中国危重病急救医学》2008年第5期268-270,共3页Chinese Critical Care Medicine

基　　金：天津市科技发展计划项目（05YFJZJC1300）

摘　　要：目的分析胆汁内胆红素对移植肝脏早期功能的预示价值。方法留取51例肝移植患者术后1～10dT管引流胆汁，总计510份标本，采用0．2μm微孔滤器过滤，以去离子水30倍、100倍稀释达检测线性范围。按术后初始功能恢复情况分为良好组（30例）、中等组（10例）和不良组（11例）。采用磺酸类结晶外消旋混合物（SCR）氧化法测定总胆红素（TBil）浓度，用酶循环法测定总胆汁酸（TBA）浓度。比较3组患者术后1～10d胆汁TBil浓度、分泌量（Q-BTBil）和直接胆红素（DBil）／TBil浓度比值，以及术后5d时3组间各指标的差异；分析术后1～10d胆汁TBil浓度与TBA浓度的相关性。结果术后1～10d，3组患者胆汁TBil浓度、Q-BTBil和DBil／TBil浓度比值均有不同程度的改善，反映早期肝功能有所恢复，各组问呈显著正相关（P〈0．05或P〈0．01）。术后5d时，功能不良组胆汁TBil浓度、Q-BTBil较良好组和中等组均显著降低，胆汁DBil／TBil浓度比值仅较良好组显著降低，差异有统计学意义（P均〈0．05）。除1d和6d外，术后10d内胆汁TBil浓度和TBA浓度均呈显著正相关（P〈0．05或P〈0．01）。结论胆汁TBil浓度、Q-BTBil及DBil／TBil浓度比值对肝移植术后早期肝功能有一定预示价值。Objective To analyse the prognostic value of analysis of bilirubin in bile for early liver function after liver transplantation. Methods The bile was filtered through 0.2 μm pall filter and was diluted 30 times with deionized water to reach the reaction linear range. Fifty-one cases of liver transplantation patients were investigated. Total bilirubin （TBil）-sulfonic crystal racemic mixture （SCR） method was used. Totally 510 bile samples for a duration of 1 - 10 post operation days （POD） were collected and tested. Bile total bilirubin （B-TBil）, the quantity of biliary bilirubin secretion （Q-BTBil） and biliary direct bilirubin （DBil）/TBil rate of groups of better liver function （group A, n= 30）, less favorable function （group B, n= 10）, and poor liver function （group C, n= 11） were analyzed. Trends of above three indexes in the 3 group were compared during 1 - 10 POD. Indexes were compared between 3 groups on POD 5. Correlation of B-TBil and bile total bile acid （B-TBA） was analyzed during 1 - 10 POD. Results B-TBil, Q-BTBil and bile DBil/TBil could reflected the recovery of early liver function by clinical observation on 3 groups. The changes of every index was positive correlated within 1 - 10 POD between groups （P〈0.05 or P〈0.01）. On POD 5, B-TBil and Q-BTBil in group C were lower than those of in group A and B statistical significantly, biliary DBil/TBil in group C was lower than that of in group A significantly （all P〈0. 05）. B-TBil and B-TBA had positive correlations （P〈0.05 or P〈0.01） within POD 10 except POD 1 and POD 6. Conclusion B-TBil, Q-BTBil and biliary DBil/TBil rate had some prognostic value on early liver function after liver transplantation.

关 键 词：肝移植 早期肝功能 胆汁胆红素分析 

分 类 号：R657.3[医药卫生—外科学]