慢性HBV携带者血清胆汁酸及前白蛋白检测临床意义.doc

慢性HBV携带者血清胆汁酸及前白蛋白检测临床意义[摘要] 目的 探讨慢性HBV携带者血清胆汁酸（TBA）、前白蛋白（PA）测定的临床意义。方法 分别检测152例慢性HBV携带者（观察组）及150例健康体检者（对照组）的血清胆汁酸、前白蛋白水平并进行分析。结果 观察组血清TBA、PA异常检出率明显增高，与正常对照组比较差异显著（均P＜0.01）；观察组血清TBA水平（19.78±7.24）μmol/L，PA水平（178.30±59.25）mg/L；对照组TBA水平（5.02±3.03）μmol/L，PA水平（291.80±29.35）mg/L，两组比较差异显著（均P＜0.01）。结论 联合检测慢性HBV携带者血清TBA和PA有助于发现肝脏合成及代谢功能的早期损害。 [关键词] 慢性HBV携带者；胆汁酸；前白蛋白 [中图分类号] R512.6+2 [文献标识码] B [文章编号] 1673-9701（2011）32-86-02 The Clinical Significance of Testing the Serum Bile Acid and Prealbumin of Chronic HBV Carriers ZHENG Zhixin CHEN Chuangkun CHEN Yanshan Department of Infectious Diseases, Chenghai People’s Hospital of Shantou City in Guangdong Province, Shantou 515800, China [Abstract] Objective To study the clinical significance of testing serum bile acid （TBA） and prealbumin （PA） of the chronic HBV carriers. Methods The serum levels of bile acid and prealbumin in 152 cases of chronic HBV carriers （the observation group） and 150 cases of the physical examination （control group） were respectively detected and analyzed. Results The levels of TBA and PA in the observation group were higher than those in the normal control group, and the differences were statistically significant （P＜0.01）; The levels of TBA, PA were （19.78±7.24）μmol/L and （178.30±59.25）μmol/L in the observation group, and the levels of TBA, PA were （5.02±3.03）μmol/L and （291.80±29.35）μmol/L in the control group, and the differences between the two groups were statistically significant （P＜0.01）. Conclusion Joint detection of TBA and PA in serum of chronic HBV carriers can help to find the early damage to the liver metabolism. [Key words] Chronic HBV carriers; Bile acid; Prealbumin HBV感染严重威胁人类健康，我国属HBV感染地方性流行区。2007年最新的流行病学调查表明，我国现有HBV携带者约9000万人，每年因HBV导致的肝硬化和肝癌死亡30余万例，是一个严重的公共卫生问题[1]。慢性HBV携带者无任何临床症状，用常规肝功能检查均正常，但临床行肝穿活组织病理检查可发现部分慢性HBV携带者肝脏有不同程度炎症、纤维化、肝硬化表现，说明常规肝功能检查敏感性较差。虽然肝活检病理检查是诊断肝炎、肝纤维化的金指标，但属有创性检查，存在一定的风险，患者依从性差，特别是在基层医院更难开展。目前对慢性HBV携带者的治疗还处于不完善的状态，许多患者疏于治疗。为了寻求一种能方便、敏感反映慢性HBV携带者肝功能