不同Child-Pugh分级的肝炎肝硬化患者血清糖皮质激素水平的比较及其与证候要素的相关性  

Comparison of serum GC levels in patients with hepatitis and cirrhosis in different Child-Pugh classification and their correlation with the syndrome factors

作　　者：任红[1] 王天芳[1] 吴秀艳[1] 薛晓琳[1] 李昕[1] 赵丽红[1] 李宁[1] 李永纲[2] 赵丰润 张晓娜[1] 侯帅颖 张佳园 刘路路[1] 

机构地区：[1]北京中医药大学基础医学院,北京100029 [2]中国人民解放军第三0二医院

出　　处：《中西医结合肝病杂志》2016年第1期14-17,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:比较不同Child-Pugh分级的肝炎肝硬化患者血清糖皮质激素(GC)水平,探讨其与中医常见病性类证候要素的相关性。方法:运用本课题组统一制定的《肝炎肝硬化临床信息采集表》,进行全国多中心的横断面流行病学调查,收集患者的一般情况、症状等信息,采集血液标本并统一检测GC;依据课题组形成的专家共识《肝炎肝硬化常见证候要素辨识标准》,判定患者的病性类证候要素;将测得GC值的711例肝炎肝硬化患者按照Child-Pugh分级标准分为A级、B级、C级3组,Child-A级组277人,Child-B级组286人,Child-C级组148人,分别分析Child-Pugh A、B、C级3组肝炎肝硬化患者血清GC水平的差异及其与血瘀、阴虚、湿热、气滞、气虚、阳虚、水停诸病性类证候要素的相关性。结果:随着Child-Pugh分级的增加,肝炎肝硬化患者血清GC水平逐渐升高,3组差异有统计学意义(P<0.01);在Child A级组中,诸证候要素判定组患者GC水平与非判定组患者差异均无显著性意义(P>0.05);在Child-B级组中,诸证候要素(除水停外)判定组患者的GC水平均高于非判定组,其中气滞和气虚判定组患者的GC水平显著高于非判定组(P<0.05);在Child C级组中,诸证候要素判定组患者的GC水平均高于非判定组,其中血瘀和气滞判定组患者GC水平显著高于非判定组(P<0.05)。结论:肝炎肝硬化患者血清GC水平能够反映肝脏的储备功能和病情的严重程度,且初步提示与中医常见病性类证侯要素之间有一定相关性。Objective： To compare the Serum glucocorticoid（GC） levels in patients with hepatitis and cirrhosis in different ChildPugh classification and to analyze the correlation between serum GC levels and common TCM syndrome elements. Method： Using a unified ＂hepatitis cirrhosis clinical information collection list＂, which was formulated by this team, to do a national multicenter cross-sectional epidemiol- ogical survey and to collect the general condition of patients, symptoms and other information. At the same time, collect blood samples and unify detection index in order to determine the patient＇s TCM syndrome elements based on the expert consensus＂cirrhosis common syndrome factors identification standards＂ which was formed in group. To divided the 711 cases whose Serum GC were measured into three groups ： A grade 277 cases, B grade 286 cases and C grade 148 cases, to compare the Serum glucocorticoid（GC） levels in patients with hepatitis and cirrhosis in different Child-Pugh classification and to analyze the correlation between serum GC levels and common TCM syndrome elements. Results： With the increase of Child-Pugh grade, the level of serum GC in patients with hepatitis and cirrhosis increased gradually, there was a significant difference amoung three groups （P〈0.05）. In the Child-A grade group, the correlation between serum GC levels and common TCM syndrome elements was not statistically significant （P〉 0.05）. In the Child-B grade group, except the water retention, the serum GC level of all the TCM syndrome elements judgment group was higher than non- judgment group. But only the Qi stagnation and qi deficiency judgment of patients was significantly higher than the non-determination group （P 〈0.05）. In the Chitd-C grade group, the serum GC levels of all the TCM syndrome elements judgment group was higher than non-judgment group. Only qi stagnation and blood stasis group was significantly higher than the non judging group （P〈O.05）. Conclusion： The serum GC levels in

关 键 词：肝炎肝硬化 血清糖皮质激素 证候要素 CHILD-PUGH分级 

分 类 号：R575[医药卫生—消化系统]