血清维生素B12、叶酸变化用于评估慢性乙型肝炎肝硬化患者肝损伤程度价值分析  

Value of serum vitamin B_(12) and folic acid changes on evaluating the degree of liver injury in patients with chron⁃ic hepatitis B cirrhosis

作　　者：郭婷婷 高琳 徐佳佳 许美芬 GUO Tingting;GAO Lin;XU Jiajia(Department of Clinical Laboratory,Taizhou Central Hospital(Taizhou University Hospital),Taizhou 318000,China)

机构地区：[1]台州市中心医院(台州学院附属医院)检验科,浙江台州318000

出　　处：《全科医学临床与教育》2022年第2期146-148,共3页Clinical Education of General Practice

摘　　要：目的分析血清维生素B_(12)(VitB_(12))、叶酸(FA)水平对慢性乙型肝炎(CHB)肝硬化患者肝损伤的评估价值。方法选取114例CHB肝硬化患者,根据肝功能Child-Pugh分级,将其分为Child-Pugh A级、B级和C级,比较三组患者的血清VitB_(12)、FA、丙谷转氨酶(ALT)、谷草转氨酶(AST)及总胆红素(TBIL)水平;采用Spearman相关系数分析血清VitB_(12)、FA水平与肝功能分级的相关关系;所有患者进行为期1年的随访,记录其生存状况,分析血清VitB_(12)、FA对患者死亡的预测价值。结果随着患者肝功能分级的增加,其血清VitB_(12)、ALT、AST及TBIL水平呈上升趋势,血清FA水平呈下降趋势(F分别=102.03、314.63、292.52、438.99、20.00,P均<0.05)。Spearman相关系数分析显示,血清VitB_(12)水平与肝功能分级呈正相关(r=0.63,P<0.05),FA水平与肝功能分级呈负相关(r=-0.39,P<0.05);存活组患者的血清VitB_(12)水平明显低于死亡组,FA水平明显高于死亡组,差异均有统计学意义(t分别=20.90、3.39,P均<0.05)。结论血清VitB_(12)、FA水平与肝功能损伤程度密切相关,与CHB肝硬化患者预后相关。Objective To analyze the evaluated value of levels of serum vitamin B_(12)(VitB_(12))and folic acid(FA)on liver injury in patients with chronic hepatitis B(CHB)cirrhosis.Methods A total of 114 patients with CHB cirrhosis were selected and divided into Child-Pugh grade A,grade B and grade C according to the Child-Pugh classification of liver function.The levels of serum VitB_(12),FA,alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)were compared among the three groups.Spearman correlation coefficient was used to analyze the correlation between levels of serum VitB12 and FA and liver function grading.All patients were followed up for 1 year,and the survival status was recorded and the predictive value of serum VitB_(12) and FA on the death of patients was analyzed.Re⁃sults With the increase of liver function grading of patients,the levels of serum VitB_(12),ALT,AST and TBIL showed up-ward trends while the level of serum FA showed downward trend,and the differences among the three groups were statisti-cally significant(F=102.03,314.63,292.52,438.99,20.00,P<0.05).Spearman correlation coefficient analysis showed that serum VitB_(12) level was positively correlated with liver function grading(r=0.63,P<0.05),and FA level was negatively correlated with liver function grading(r=-0.39,P<0.05).The level of serum VitB_(12) of patients in survival group was significantly lower than that in death group while the FA level was significantly higher than that in death group(t=20.90,3.39,P<0.05).Conclusion Serum VitB_(12) and FA levels are closely related to the degree of liver injury,and cor-relate the prognosis of patients with CHB cirrhosis.

关 键 词：维生素B12 叶酸 慢性乙型肝炎 肝硬化 肝损伤 

分 类 号：R575.2[医药卫生—消化系统] R512.62[医药卫生—内科学]