血清视黄醇结合蛋白在肝病诊断中的应用.docVIP

血清视黄醇结合蛋白和前白蛋白在肝病诊断中的应用 摘要 目的　探讨血清视黄醇结合蛋白（RBP）、前白蛋白（PA）在不同类型肝病诊断中的临床意义。方法　用免疫比浊法检测117例不同类型肝病患者及86例正常人的血清RBP、PA水平，用溴甲酚绿法白蛋白ALB），并对其中48例急性肝炎患者作动态观察。结果　急性肝炎患者入院时血清RBP、PA明显下降，血清ALB下降不明显，治疗一个月后血清RBP、PA明显回升，而血清ALB明显下降；慢性肝炎患者血清RBP、PA、ALB偏低，与正常对照组比较无显著差异；肝炎后肝硬化患者血清RBP、PA、ALB均下降。结论　血清RBP、PA可作为反映急性肝损害的敏感指标，优于血清ALB，对肝病的诊断和预后判断有重要参考价值。 关键词 肝炎；视黄醇结合蛋白；前白蛋白；白蛋白 Abstract: Objective To explore the value of combining detecting of serum RBP(Retinol binding protein) and PA(Prealbumine) in diagnosis of different liver disease. Methods 117 cases of different liver diseases and 86 cases of healthy adults were detected the serum levels of RBP and PA with the method of Immunoturbidimetry and the levels of serum ALB(Albumine) with the method of Bromocresol green . 48 cases of acute hepatitis were observed dynamic. Results The acute hepatitis patients serum levels of RBP and PA declined significantly and serum levels of ALB declined unconspicuously. After they were cured for a month ,the serum levels of RBP and PA ascended distinctly .At the same time the serum levels of ALB declined visibly. The chronic hepatitis patients serum levels of RBP、PA and ALB were little lower. There were no differences for the cases of healthy adults.The serum levels of RBP、PA and ALB of the hepatocirrhosis patients causing of hepatitis all declined .Conclusions The serum RBP and PA which are sensitive indexes reflecting liver damnification are better than serum ALB. It is valuable to measure the levels of RBP and PA in diagnosis and prognosis judgement of liver disease. Keyword : Hepatitis ; Retinol binding protein ; Prealbumine ; Albumine 为探讨视黄醇结合蛋白（RBP）、前白蛋白（PA）在肝病诊断中的临床价值，用免疫比浊法检测117例不同类型肝病患者及86例正常人的血清RBP、PA水平，同时用溴甲酚绿法白蛋白ALB），并对其中48例急性肝炎患者作动态观察。现报道如下： 1 材料与方法 1.1 研究对象　117例不同类型的肝炎患者均为2006年3月～2007年5月期间我院及第一人民医院传染科门诊及住院患者，其中男60例，女57例；平均年龄38.6（10～62）岁。按2000年西安会议标准[1]进行诊断分型：急性肝炎48例、慢性肝炎42例、肝炎后肝硬化27例；其中105例为乙型肝炎，12例为丙型肝炎。86例正常对照为来我院体检的健康成人，男45例，女41例，平均年龄38.2（18～58）岁，均排除肾、肝功能损害或营养不良性疾病。 1.2 检验方法