血清总胆汁酸和4项肝纤维化指标与肝硬化Child-Pugh分级的关系.pdfVIP

· 756· Chin J Gastroenterol，2007，Vo1．12，No．12 · 短 篇 论 著 · 血清总胆汁酸和4项肝纤维化指标与肝硬化Child·Pugh分级的关系 张 利 朱海杭 徐永居 江苏省苏北人民医院消化科(225001) 背景：血清总胆汁酸(TBA)以及肝纤维化指标Ⅲ型前胶原(PC19)、Ⅳ型胶原(C一Ⅳ)、层黏蛋白(LN)和透明质酸 (HA)水平可判断肝硬化程度，但国内外研究关于肝纤维化指标与Child—Pugh分级关系的结果并不完全一致。目的： 研究肝硬化患者血清 IBA含量以及PCⅢ、C．Ⅳ、LN、HA水平与肝硬化Child—Pugh分级的关系。方法：按 Child．Pugh 分级标准将42例肝硬化患者分为A、B、C三级，酶法测定血清TBA含量，放射免疫测定法检测空腹血清PC19、C． 1V、LN、HA水平。结果：血清TBA含量随Child．Pugh分级增高而升高，不同分级间有显著差异(P0．01)。肝功能C级 患者血清PC19水平显著高于A级患者(P0．05)，各级肝功能患者间血清C一Ⅳ水平均无显著差异．肝功能C级患者 血清LN水平显著高于A级和B级患者(P0．0l，P0．05)，肝功能B级和C级患者血清HA水平均显著高于A级患 者(P0．01)。结论：血清TBA含量能灵敏地反映肝硬化患者肝功能损害程度，对指导肝硬化患者肝功能分级具有很 好的参考价值；联合检测肝硬化患者血清PC19、LN、HA对指导肝功能的分级也有一定意义。 关键词 胆酸； 肝硬化； 前胶原； 胶原Ⅳ型； 层黏连蛋白； 透明质酸； Child．Pugh分级 Relationship between Serum Total Bile Acid,Four Liver Fibrolic Markers and Child-Pugh Staging ZHA NG Li, ZHUHaihang,XU Yon~u．Department ofGastroenterology,SubeiPeople’s Hospital,Yangzhou,Jiangsu Province(225001) Background：Detection of serum total bile acid(TBA)，type 19 precollagen(PCⅢ)，type IVcollagen(C-IV)，laminin (LN)and hyaluronic acid(HA)can be used for judging the grading of liver fibrosis．However，studies on the relationship between liver fibrotic markers with Child．Pugh staging are still controversial either at home or abroad． Aims： To investigate the relationship between TBA，PC 19，C-IV，LN，HA and Child-Pugh staging．Methods：Foay-two cirrhotic patients were divided into stage A， B and C according to Child-Pugh staging．Serum TBA level was detected by enzymic method．Levels of serum PC 19．C．IV．LN and HA were detected by radioimmunoassay．Results：Level of serum TBA increased as Child-Pugh staging increased．and significant differences were observed in patients with different stages (P 0．01)．Level of serum PC 19 in patient