25-(OH)D对胆汁性肝硬化患者的诊断效果研究  

Diagnostic effect of 25-(OH)D on patients with biliary cirrhosis

作　　者：张莉[1] 郁淼[1] 周晔[1] 冷俊[1] ZHANG Li;YU Miao;ZHOU Ye;LENG Jun(Department of Clinical Laboratory, Chongming Branch of Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 202150, CHINA)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院检验科,上海202150

出　　处：《海南医学》2018年第24期3411-3413,共3页Hainan Medical Journal

基　　金：上海市崇明县科学技术发展资金攻关项目(编号:CKY2012-15)

摘　　要：目的研究25羟维生素D [25-(OH)D]对原发性胆汁性肝硬化(PBC)患者的诊断效果。方法选取2014年6月至2016年9月于上海交通大学医学院附属新华医院崇明分院确诊的74例PBC患者为研究对象(PBC组),同时将研究期间于我院进行体检的66例健康体检者作为对照组。比较两组受检者的总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、碱性磷酸酶(ALP)及γ-谷氨酰转肽酶(γ-GT)、球蛋白(GLB)、白蛋白(ALB)等生化指标、血清25-(OH)D含量以及Child-Pugh不同肝硬化分级患者的血清25-(OH)D含量。结果 PBC组和对照组受检者的TBIL含量[(51.18±10.91)μmol/L vs (17.49±4.76)μmol/L]、DBIL [(41.43±6.77)μmol/L vs (5.71±0.870)μmol/L]、IBIL[(37.58±8.17)μmol/L vs (6.27±2.14)μmol/L]、ALB [(37.09±4.79) g/L vs (34.17±5.11) g/L]、GLB[(36.19±6.03) g/L vs(34.48±5.79) g/L]、ALP [(107.83±23.41) U/L vs (71.22±16.43) U/L]和γ-GT [(109.43±32.19) U/L vs (24.11±9.15)U/L]比较,PBC组患者均明显高于对照组,差异均有统计学意义(P<0.05);PBC组患者的25-(OH)D含量为(27.49±6.11) ng/m L,明显高于对照组的(11.65±3.19) ng/mL,差异有统计学意义(P<0.05);PBC组患者中A级21例,25-(OH)D含量为(21.38±5.13) ng/m L,B级34例,25-(OH)D含量为(19.26±4.12) ng/m L,C级19例,25-(OH)D含量为(15.23±4.75) ng/m L,ABC三级患者的25-(OH)D含量逐渐降低,差异有统计学意义(P<0.05)。结论胆汁性肝硬化患者的25-(OH)D含量低于正常水平,且随着病情严重程度的增加25-(OH)D含量降低,提示25-(OH)D可以为胆汁性肝硬化的诊断提供依据。Objective To explore the diagnostic effect of 25-(OH)D on patients with primary biliary cirrhosis (PBC). Methods Seventy-four patients with PBC diagnosed from June 2014 to September 2016 at Chongming Branch of Xinhua Hospital, Shanghai Jiaotong University School of Medicine were selected as subjects (PBC group), and 66 healthy subjects in the hospital for physical examination were selected as a control group. Total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), alkaline phosphatase (ALP), and γ-glutamyltranspeptidase (γ-GT), globulin (GLB), and albumin (ALB), serum 25-(OH)D content, and serum 25-(OH)D levels in patients with different cirrhosis grades of Child-Pugh were compared. Results The TBIL, DBIL, IBIL, ALB, GLB, ALP, γ-GT levels in the PBC group were all significantly higher than those in the control group (P<0.05): TBIL (51.18±10.91) μmol/L vs (17.49±4.76) μmol/L,DBIL (41.43±6.77) μmol/L vs (5.71±0.870) μmol/L, IBIL (37.58±8.17) μmol/L vs (6.27±2.14) μmol/L, ALB (37.09±4.79) g/L vs (34.17±5.11) g/L, GLB (36.19±6.03) g/L vs (34.48±5.79) g/L, ALP (107.83±23.41) U/L vs (71.22±16.43) U/L,γ-GT (109.43±32.19) U/L vs (24.11±9.15) U/L. The 25-(OH)D content of PBC group was (27.49±6.11) ng/mL, signifi cantly higher than (11.65±3.19)ng/mL in the control group (P<0.05).The level of 25-(OH)D was (21.38±5.13)ng/mL for the 21 patients with grade A,(19.26±4.12)ng/mL for the 34 patients with grade B,(15.23±4.75)ng/mL for the 19 pa tients with grade C,and the differences among the three groups were statistically significant (P<0.05).Conclusion The 25-(OH)D content in patients with biliary cirrhosis is lower than normal,and it decreases with the severity of the disease,which can provide a basis for the diagnosis of biliary cirrhosis.

关 键 词：25羟维生素D 胆汁性肝硬化 诊断效果 胆红素 碱性磷酸酶 球蛋白 白蛋白 

分 类 号：R575.22[医药卫生—消化系统]