肝硬化Child-Pugh法分级与血清中糖类抗原125前白蛋白及胆碱酯酶的关系

摘要

目的 通过检测肝硬化患者血清中糖类抗原125(CA125)、前白蛋白(PA)及胆碱酯酶(CHE),探讨其与肝硬化程度的关系. 方法 本研究收集2015年1月至2017年3月在我院就诊的155例老年肝硬化患者作为肝硬化组,患者年龄61～81岁,平均(65.5±6.2)岁.另随机选取50例老年健康受试者血清样品作为对照组,对照组年龄60～79岁,平均(67.3±5.2)岁.通过Child-Pugh法对肝硬化患者的肝硬化程度进行分级,并检测肝硬化患者和对照组血清中的CA125、PA及CHE水平. 结果 与对照组比较,肝硬化患者血清中CA125显著升高,PA、CHE水平显著降低(t=8.41、11.03、23.05,均P=0.000).Child-Pugh分级A、B、C级分别有63例、51例、41例,血清CA125值分别为(43.55±23.71) μg/L、(157.22±57.18)μg/L、(261.28±131.98)μg/L;血清PA值分别为(176.81±55.18)mg/L、(135.23±39.98) mg/L、(89.27±49.11) mg/L;血清CHE值分别为(4 727.46±998.10) U/L、(2 451.016±528.81)U/L、(1 962.58±439.14) U/L;随着肝硬化分级增加、病情加重,血清CA125呈进行性增加趋势、PA值和CHE值则逐渐下降(F=102.33、177.61、208.95,均P=0.000),且组间两两比较均有统计学意义(均P＜0.05). 结论 CA125、PA和CHE在老年肝硬化患者病情诊断及预后恢复等方面具有重要的临床参考价值.%Objective To evaluate the relationship between cirrhosis degree and the level of serum CA125,pre-albumin (PA) and cholinesterase (CHE) in aged patients with cirrhosis.Methods One hundred and fifty-five patients with liver cirrhosis admitted to the Second People's Hospital of Tongxiang from December 1st 2013 to December 1st 2015 were selected as the observation group.The age of the patient was 61～81 years,with an average age of (65.5±6.2) years.The degree of patient liver cirrhosis was graded by Child-Pugh (CP) score.Fifty healthy individuals from 60 to 79 years old,average (67.3±5.2) years were selected as the control group.Four indicators were detected in all research objects,including CA125,PA and CHE.Spearman correlation analysis was carried out between liver cirrhosis grading and each index changes.Results Compared to the healthy groups,the patients with liver cirrhosis had a higher levels of CA125,which was a positively correlated with cirrhosis degree.Patients with CP score A,B,C liver function had significantly different levels of CA125 [(43.55± 23.71) μg/L,(157.22 ± 57.18) μg/L,(261.28 ± 131.98) μg/L,respectively,F=102.33,P=0.000],PA [(176.81±55.18) mg/L,(135.23 ± 39.98) mg/L,(89.27 ±49.11) mg/L,respectively,F=177.61,P=0.000] and CHE [(4 727.46±998.10) U/L,(2 451.016±528.81) U/L,(1 962.58±439.14) U/L respectively,F=208.95,P=0.000].Patients with liver cirrhosis were associated with lower levels of PA and CHE than those in the healthy participants,which were negatively correlated with cirrhosis degree.Conclusions The CA125,PA and CHE have an important clinical significance in diagnosis,conditions' evaluation and prognosis' assessment for cirrhosis.