血清前白蛋白、视黄醇结合蛋白和总胆汁酸在肝硬化分级诊断中的意义

摘要

Objective:To investigate the role of prealbumin (PA), retinol binding protein (RBP) and total bile acid (TBA) in Child-Pugh classification of hepatic cirrhosis. Methods: One hundred and twenty patients with hepatic cirrhosis were enrolled and divided into three groups according to Child-Pugh standard, A group (A grade, 40 cases), B group (B grade,42 cases) and C group (C grade,38 cases), respectively. And 40 healthy cases were as normal control. Automatic biochemistry analysator was used to assay serum PA, RBP and TBA. Results: The levels of PA and RBP were significantly lower in patients with hepatic cirrhosis than those in normal control(P ＜ 0.01 or P ＜ 0.05), and decreased gradually with the elewtion of Child-Pugh classifieation, which was significantly different between three groups(P ＜ 0.01 or P ＜ 0.05). However, the level of TBA was significantly higher in patients with hepatic cirrhosis than that in normal control group(P ＜ 0.01 or P ＜ 0.05), and elevated gradually with the increase in Child-Pugh classification. There was also a significant difference between three groups (P ＜ 0.01 or P ＜ 0.05). Conclusion: There was a clinical significance in PA, RBP and TBA to evaluate the classification and prognosis in patients with hepatic cirrhosis.%目的:探讨血清前白蛋白(PA)、视黄醇结合蛋白(RBP)和总胆汁酸(TBA)在肝硬化Child-Pugh分级中的作用.方法:120例肝硬化患者按Child-Pugh分级标准分为A组(A级)40例,B组(B级)42例,C组(C级)38例,另设正常对照组40例.采用自动生化分析仪分别测定各组血清PA,RBP和TBA的水平.结果:肝硬化患者血清中PA和RBP水平较对照组均减低(P<0.01或P<0.05),且随着Child-Pugh积分升高而递减,各组间比较差异均有统计学意义(P<0.01或P<0.05);而TBA较对照组明显升高,且随着Child-Pugh积分升高而递增,各组间比较差异有统计学意义(P<0.01或P<0.05).结论:联合检测PA,RBP和TBA可以较好地判断肝硬化患者分级状况,为评估患者的预后提供一定的临床价值.