肝硬化患者血总胆汁酸水平、粪便 pH 值的临床意义

摘要

Objective]To investigate the clinical value of serum total bile acid (TBA )and fecal pH in Child-pugh classification in patients with hepatic cirrhosis.[Methods]Seventy patients with hepatic cirrho-sis were enrolled and divided into three groups according to Child-pugh classification :A group(A grade ,13 cases) ,B group(B grade ,34 cases) ,C group(C grade ,23 cases) ,respectively.And 40 patients with chronic gastritis were enrolled as control.Automatic biochemistry analysator was used to measure serum TBA.Fecal pH value was detected by short range pH paper.[Results]The levels of fecal pH and serum TBA were signifycantly higher in patients with hepatic cirrhosis than those in control group (P<0.01) , which elevated gradually changes with the increase in Child-pugh classification.There were also a signifi-cant difference of serum TBA among three groups(P<0.01) ,but fecal pH was not significantly different among three groups(P>0.05).No significant correlation was found between serum TBA ,fecal pH and different causes of hepatic cirrhosis(P> 0.05).[Conclusion]Serum TBA ,fecal pH is one of the sensi-tive indexes refectiong cell damage of hepatic cirrhosis.Fecal pH is affected by many factors ,w hich has less value than serum TBA on predicting the prognosis and degree of liver function in patients with he-patic cirrhosis.%[目的]探讨血清胆汁酸（TBA）水平和粪便pH值在肝硬化中的临床价值。[方法]对70例肝硬化患者（肝硬化组）、40例慢性胃炎患者（对照组）采用全自动生化分析仪检测其 TBA、精密pH试纸检测其粪便pH值。[结果]肝硬化组患者外周血 TBA水平、粪便 pH值分别为（52.88±47.88）μmol/L、6.88±0.71，对照组分别为（8.695±4.70）μmol/L、5.860±0.27；2组比较，血清TBA水平及粪便pH值均差异有统计学意义（P＜0.01）。肝硬化组患者随着Child-pugh分级升高而TBA水平升高，各级间比较差异有统计学意义（P＜0.05）；但不同Child-pugh分级患者粪便pH值无改变。外周血TBA水平、粪便pH值与肝硬化病因无明显相关性。[结论]TBA、粪便pH值是反映肝硬化患者肝细胞损害的敏感指标之一，由于影响粪便pH值的因素较多，其预测及判断肝硬化预后及病情的严重程度的敏感性、特异性不如TBA。