乙型肝炎相关性肝功能衰竭患者血清γ-谷氨酰胺转移酶与前白蛋白的动态变化及终末期肝病评分模型评分的相关性  

The association between serum γ-glutamyl transferase and the dynamics of prealbumin/model for end stage live disease in patients with liver failure caused by hepatitis B virus

作　　者：陈丽[1] 黄小平[1] 王艳[1] 徐英[1] 孙蔚[1] 朱海超[1] 甘建和[1] 

机构地区：[1]苏州大学附属第一医院感染病科,215006

出　　处：《中华传染病杂志》2017年第12期715-718,共4页Chinese Journal of Infectious Diseases

摘　　要：目的探讨乙型肝炎相关性肝功能衰竭患者外周血γ-GT的水平及评估其对预后的指导意义。 方法检测89例肝功能衰竭患者、30例肝硬化患者以及30名健康人外周血γ-GT的水平。研究肝功能衰竭存活亚组与死亡亚组患者入院时γ-GT水平和入院后动态变化的差异，研究肝功能衰竭患者入院后γ-GT上升亚组与γ-GT下降亚组存活率的差异，研究肝功能衰竭患者血清γ-GT与终末期肝病评分模型（model for end stage live disease, MELD）评分及前白蛋白的相关性。 结果入院时，肝功能衰竭组、肝硬化组及健康对照组外周血γ-GT水平分别为（149.61±69.86）、（123.96±59.52）和（48.28±10.25） U/L，3组间差异有统计学意义（F＝178.150，P〈0.05）。肝功能衰竭存活亚组入院后1周γ-GT上升值明显高于肝功能衰竭死亡亚组，差异有统计学意义[（75.27±10.34）比（29.47±5.05） U/L，t＝5.40，P〈0.05]。入院后γ-GT上升亚组存活率明显高于γ-GT下降亚组，差异有统计学意义[76.19%（48/63）比23.08%（6/26），χ2＝21.76，P〈0.05]。肝功能衰竭组患者γ-GT与前白蛋白呈正相关性，与MELD评分呈负相关（r分别为0.709、－0.627，均P〈0.05）。 结论γ-GT的逐步升高是肝功能衰竭患者预后良好的指标之一。肝功能衰竭患者血清γ-GT与前白蛋白具有良好的正相关性，可共同反映肝细胞的再生。ObjectiveTo investigate the serum γ-glutamyl transferase （γ-GT） level and its clinical significances in hepatitis B virus （HBV）-liver failure （LF） patients. Methodsγ-GT levels were detected in 89 LF patients, 30 cases with cirrhosis and 30 healthy controls. Difference of serum γ-GT between survival group and death group in LF patients and dynamics of γ-GT after hospitalization were studied. Survival rate between γ-GT increase group and decrease group were compared. The associations of γ-GT with model for end stage live disease （MELD） and prealbumin were calculated. ResultsAt baseline, the γ-GT levels in LF, cirrhosis and healthy control groups were （149.61±69.86）, （123.96 ±59.52） and （48.28±10.25） U/L, respectively, the difference among groups was significant （F=178.150, P〈0.05）. The survival group in LF patients showed significant increase of γ-GT one week after hospitalization compared with death group （[75.27±10.34] vs [29.47±5.05], t=5.40, P〈0.05）. The γ-GT increase group showed higher survival rate than γ-GT decrease group [76.19% （48/63） vs23.08% [6/26], χ2=21.76, P〈0.05]. Serum γ-GT level in LF patients was positively correlated with both MELD score and prealbumin （r=0.709 and -0.627, respectively, both P〈0.05）. ConclusionsThe rise of γ-GT may indicate a better prognosis in LF patients. Serum γ-GT positively correlates with prealbumin and both could reflect the regeneration of hepatocytes.

关 键 词：肝功能衰竭 前白蛋白 Γ-谷氨酰转肽酶 

分 类 号：R512.62[医药卫生—内科学] R575.3[医药卫生—临床医学]