血清PA ChE和TBA水平与肝硬化门静脉高压伴上消化道出血的关系  

Relationship of Serum PA ChE and TBA Levels with Cirrhotic Portal Hypertension Complicated by Upper Gastrointestinal Bleeding

作　　者：张欢[1] 李小安 刘华柱[1] 张丽丽[1] 马欢[1] 黄小梅 ZHANG Huan;LI Xiao'an;LIU Huazhu(Mianyang Central Hospital,Sichuan Mianyang 621000,China)

机构地区：[1]四川省绵阳市中心医院消化内科,四川绵阳621000

出　　处：《河北医学》2022年第1期47-51,共5页Hebei Medicine

基　　金：四川省卫生健康委员会基金项目,(编号:20PJ263)。

摘　　要：目的:探讨血清前白蛋白(PA)、胆碱酯酶(ChE)和总胆汁酸(TBA)水平与肝硬化门静脉高压伴上消化道出血的关系。方法:选取2019年1月至2021年4月我院收治的肝硬化门静脉高压伴上消化道出血患者273例(肝硬化出血组),肝功能分级A级58例,B级119例,C级96例。选取同期无肝硬化病史的胃十二指肠溃疡引起的上消化道出血患者82例(非肝硬化出血组)。选取无肝硬化病史的健康志愿者65例(健康对照组)。比较3组血清PA、ChE、TBA水平,分析血清PA、ChE、TBA水平与肝功能分级的相关性。结果:肝硬化出血组的血清PA、ChE水平低于非肝硬化出血组和健康对照组(P<0.05),肝硬化出血组的血清TBA水平高于非肝硬化出血组和健康对照组(P<0.05)。C级患者的血清PA、ChE水平低于B级和A级(P<0.05)。C级患者的血清TBA水平高于B级和A级(P<0.05)。血清PA、ChE水平与肝功能分级呈负相关(rs=-0.553,rs=-0.439,P均<0.05)。血清TBA水平与肝功能分级呈正相关(rs=0.628,P<0.05)。结论:肝硬化门静脉高压伴上消化道出血患者的血清PA和ChE呈低水平,血清TBA呈高水平;血清PA、ChE和TBA与患者的肝功能分级密切相关。Objective:To investigate the relationship of serum prealbumin(PA),cholinesterase(ChE)and total bile acid(TBA)levels with cirrhotic portal hypertension complicated by upper gastrointestinal bleeding.Methods:A total of 273 patients with cirrhotic portal hypertension and upper gastrointestinal bleeding(cirrhosis bleeding group)were selected between January 2019 and April 2021,including 58 patients with grade A liver function,119 patients with grade B liver function,and 96 patients with grade C liver function.Meanwhile,82 patients with upper gastrointestinal bleeding caused by gastroduodenal ulcer and without history of liver cirrhosis were selected as the non-cirrhosis bleeding group,and 65 healthy volunteers without history of liver cirrhosis were selected as the healthy control group.Serum PA,ChE and TBA levels in the 3 groups were compared.The correlation of serum PA,ChE and TBA levels with liver function classification was analyzed.Results:Serum PA and ChE levels in the cirrhosis bleeding group were lower than those in the non-cirrhosis bleeding group and the healthy control group(P<0.05),while serum TBA levels were higher than those in the non-cirrhosis bleeding group and the healthy control group(P<0.05).Serum PA and ChE levels of patients with grade C liver function were lower than those of patients with grade B and grade A(P<0.05),while serum TBA levels were higher than those of patients with grade B and grade A(P<0.05).Serum PA and ChE levels were negatively correlated with the grade of liver function(rs=-0.553,rs=-0.439,P<0.05),while serum TBA level was positively correlated with the grade of liver function(rs=0.628,P<0.05).Conclusion:Patients with cirrhotic portal hypertension and upper gastrointestinal bleeding have low serum PA and ChE levels,and high serum TBA level.Serum PA,ChE and TBA are closely related to liver function classification of the patients.

关 键 词：肝硬化 门静脉高压 上消化道出血 前白蛋白 胆碱酯酶 总胆汁酸 

分 类 号：R575.2[医药卫生—消化系统] R573.2[医药卫生—内科学]