血浆铜蓝蛋白在乙型肝炎不同肝功能状态的水平及意义  

The levels and significance of ceruloplasmin in hepatitis B with different liver function status

作　　者：杨波[1] 吴元凯[1] 曹红[1] 陈忠诚[2] 高志良[1] 柯伟民[1] 

机构地区：[1]中山大学附属第三医院传染病学教研室,广东广州510630 [2]中山大学附属第三医院检验科,广东广州510630

出　　处：《胃肠病学和肝病学杂志》2012年第9期841-843,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：根据科技重大专项"十二五"课题:艾滋病和病毒性等重大传染病防治(20012ZX10002007)

摘　　要：目的探讨肝豆状核变性、乙型肝炎不同肝功能状态时血浆铜蓝蛋白水平的差异及其临床意义。方法用终末期肝病模型(model for end-stage liver disease,MELD)评分衡量肝功能损害的严重性,采用散射比浊法检测并比较分析肝豆状核变性、慢加急性肝衰竭极期以及恢复期、慢性乙型肝炎患者的血浆铜蓝蛋白水平。结果肝豆状核变性(n=50)、慢加急性肝衰竭极期和恢复期(n=30)、慢性乙型病毒性肝炎患者(n=50)的MELD评分分别为11.1±6.5、20.4±4.2、10.9±4.9、9.6±9.8,血浆铜蓝蛋白分别为(0.065±0.036)g/L、(0.176±0.037)g/L、(0.210±0.056)g/L、(0.197±0.038)g/L;血浆铜蓝蛋白水平4组之间的两两比较存在差异(F=111.4,P<0.001),肝豆状核变性患者低于其他3组(P<0.001)。结论肝豆状核变性血浆铜蓝蛋白水平显著降低。相对于肝豆状核变性,没有肝衰竭的慢性乙型肝炎血浆铜蓝蛋白水平几乎正常。慢加急性肝衰竭极期血浆铜蓝蛋白水平仅轻度下降,随着肝功能衰竭的恢复,血浆铜蓝蛋白恢复正常。Objective To clarify the difference and significance of ceruloplasmin levels in patients with Wilson＇ s disease and chronic hepatitis B patients with different liver function status. Methods Model for end-stage liver disease （MELD） was used to measure severities of liver function injury. The levels of eeruloplasmin in patients with Wilson＇ s disease, patients at the fastigium and convalescent period of acute-on-chronic liver failure with hepatitis B and in pa- tients with chronic hepatitis B were measured by nephelometrie immunoassay. Results The MELD scores in patients with Wilson＇ s disease （ n = 50） , fastigum and convalescent period of acute-on-chronic liver failure with hepatitis B （ n =30） , chronic hepatitis B （n =50） were 11.1 ±6.5, 20.4 ±4.2, 10.9 ±4.9 and 9.6 ±9.8, respectively, and the levels of ceruloplasmin in those patients were （0. 065 ± 0. 036） g/L, （0. 176 ± 0. 037 ） g/L, （0. 210 ± 0. 056） g/L and （0. 197 ± 0. 038 ） g/L, respectively. There were statistically significant differences among the four groups （ F = 111.4, P 〈0. 001 ）. The level of eeruloplasmin in Wilson＇ s disease patients was significant lower than that in the other groups （P 〈 0. 001 ）. Conclusion Ceruloplasmin level is remarkably decreased in patients with Wilson＇ s disease. Compared with Wilson＇ s disease, ceruloplasmin level is almost normal in patients with chronic hepatitis B without liver failure. Ceruloplasmin level just is decreased slightly at the fastigium of acute-on-chronic liver failure with hepatitis B and re- turned to normal level along with the recovery of liver failure.

关 键 词：血浆铜蓝蛋白 肝豆状核变性 慢加急性肝衰竭 慢性乙型肝炎 

分 类 号：R512.62[医药卫生—内科学]