乙型肝炎肝硬化并腹水患者肝功能评估时的部分相关因素分析
赖力英, 杨旭, 龚国忠, 蒋永芳, 邹文, 中南大学湘雅二医院肝病研究中心 湖南省长沙市 410011
通讯作者:赖力英, 410011, 湖南省长沙市芙蓉区人民路, 中南大学湘雅二医院肝病研究中心. lailiying@mail.csu.edu.cn
电话: 0731-5524222-2263 传真:0731-5533525
收稿日期: 2005-01-17 接受日期: 2005-02-02
摘要
目的:分析乙型肝炎肝硬化并腹水患者肝功能评估时的相关因素，寻找对判断病情有指导意义的非创伤性指标.
, 百拇医药
方法:收集在本院住院的乙型肝炎肝硬化并腹水病例共126例，排除合并其他病毒感染，按Child-Pugh肝功能评分法评分并分级，分析患者血清常用生化指标ALT、AST、ALB、GLB、TBIL、TBA与不同肝功能级别的关系
结果:126例乙型肝炎肝硬化并腹水患者中A级15例、B级73例、C级38例.血清ALT、AST、ALB、GLB、TBIL、TBA的异常率依次为39.68%、 84.21%、 89.68%、 70.16%、 95.32%、91.26%，P值依次为0.25-0.5、<0.005、<0.005、0.1-0.25、<0.005、<0.005，敏感性从高到低依次为TBA、TBIL、ALB、AST、GLB、ALT.ALT、AST、ALB、GLB、TBA均值在男性和女性患者之间差异无显著性(P>0.05);TBIL在男性和女性患者之间差异有极显著性(P= 0.001).ALT均值在C级与A级之间的差异有显著性;AST、TBA、TBIL均值在A与B级、B与C级、C与A级之间的差异均有显著性(P<0.05)，其中A与B级、C与A级之间的差异有极显著性(P<0.01);ALB均值在各级之间的差异均有极显著性(P<0.01);GLB在各级之间的差异均无显著性(P>0.05).
, 百拇医药
结论:在乙型肝炎肝硬化并腹水患者中，按Child-Pugh肝功能评分法评分并分级后，常用生化指标敏感性从高到低依次为TBA、TBIL、ALB、AST、ALT，血清AST及TBA数值与肝功能分级有良好的相关性.
赖力英, 杨旭, 龚国忠, 蒋永芳, 邹文. 乙型肝炎肝硬化并腹水患者肝功能评估时的部分相关因素分析. 世界华人消化杂志 2005;13(6):799-803
Li CP, Lee FY, Hwang SJ, Lu RH, Lee WP, Chao Y, Wang SS, Chang FY, Whang-Peng J, Lee SD. Spider angiomas in
patients with liver cirrhosis: role of vascular endothelial growth factor and basic fibroblast growth factor.
, 百拇医药
World J Gastroenterol 2003;9:2832-2835
3 Giannini E, Botta F, Testa E, Romagnoli P, Polegato S, Malfatti F, Fumagalli A, Chiarbonello B, Risso D, Testa R. The
1-year and 3-month prognostic utility of the AST/ALT ratio and model for end-stage liver disease score in patients
with viral liver cirrhosis. Am J Gastroenterol 2002;97:2855-2860
4 Pohl A, Behling C, Oliver D, Kilani M, Monson P, Hassanein T. Serum aminotransferase levels and platelet counts
, 百拇医药
as predictors of degree of fibrosis in chronic hepatitis C virus infection. Am J Gastroenterol 2001;96:3142-3146
5 Khokhar N. Serum aminotransferase levels and platelet count as predictive factor of fibrosis and cirrhosis in patients
with chronic hepatitis C infection. J Pak Med Assoc 2003;53:101-410
6 Giannini E, Risso D, Botta F, Chiarbonello B, Fasoli A, Malfatti F, Romagnoli P, Testa E, Ceppa P, Testa R. Validity and
, http://www.100md.com
clinical utility of the aspartate aminotransferase-alanine aminotransferase ratio in assessing disease severity and
prognosis in patients with hepatitis C virus-related chronic liver disease. Arch Intern Med 2003;163:218-224
7 中华医学会传染病与寄生虫病学分会、肝病学分会联合修订. 病毒性肝炎防治方案.
中华肝脏病杂志 2000;8:324-329
8 Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding
, http://www.100md.com
oesophageal varices. Br J Surg 1973;60:646-649
9 Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients
undergoing transjugular intrahepatic portosystemic shunts. Hepatology 2000;31:864-871
10 Peng Y, Li C, Chen G, Tang C, Tang S, Li Y. A clinical analysis of alcoholic liver cirrhosis in South Sichuan area.
, 百拇医药
Zhonghua Ganzangbing Zazhi 2002;10:408-412
11 Cai WM, Tao J, Weng HL, Liu RH. Study on the influence factors of the serum fibrosis markers.
Zhonghua Ganzangbing Zazhi 2003;11:23-25
12 Salen G, Batta AK. Bile acid abnormalities in cholestatic liver diseases. Gastroenterol Clin North Am
1999;28:173-193
13 De Almeida JM, Leite-Mor MM, Parise ER. Serum concentration of bile acids in the diagnosis of chronic liver disease
, 百拇医药
and in the functional staging. Arq Gastroenterol 1998;35:81-88
14 Testa R, Valente U, Risso D, Caglieris S, Giannini E, Fasoli A, Botta F, Dardano G, Lantieri PB, Celle G. Can the MEGX
test and serum bile acids improve the prognostic ability of Child-Pugh's score in liver cirrhosis?
Eur J Gastroenterol Hepatol 1999;11:559-563
15 Yang X, Lei J, Zhang Y, Tang X, Zheng Y, Chen J. The diagnostic value and limitations of total serum bile acid
determined enzymatically. Zhonghua Neike Zazhi 2001;40:16-18
编辑 张海宁, http://www.100md.com( 赖力英,杨 旭,龚国忠, 蒋永芳,邹 文)
通讯作者:赖力英, 410011, 湖南省长沙市芙蓉区人民路, 中南大学湘雅二医院肝病研究中心. lailiying@mail.csu.edu.cn
电话: 0731-5524222-2263 传真:0731-5533525
收稿日期: 2005-01-17 接受日期: 2005-02-02
摘要
目的:分析乙型肝炎肝硬化并腹水患者肝功能评估时的相关因素，寻找对判断病情有指导意义的非创伤性指标.
, 百拇医药
方法:收集在本院住院的乙型肝炎肝硬化并腹水病例共126例，排除合并其他病毒感染，按Child-Pugh肝功能评分法评分并分级，分析患者血清常用生化指标ALT、AST、ALB、GLB、TBIL、TBA与不同肝功能级别的关系
结果:126例乙型肝炎肝硬化并腹水患者中A级15例、B级73例、C级38例.血清ALT、AST、ALB、GLB、TBIL、TBA的异常率依次为39.68%、 84.21%、 89.68%、 70.16%、 95.32%、91.26%，P值依次为0.25-0.5、<0.005、<0.005、0.1-0.25、<0.005、<0.005，敏感性从高到低依次为TBA、TBIL、ALB、AST、GLB、ALT.ALT、AST、ALB、GLB、TBA均值在男性和女性患者之间差异无显著性(P>0.05);TBIL在男性和女性患者之间差异有极显著性(P= 0.001).ALT均值在C级与A级之间的差异有显著性;AST、TBA、TBIL均值在A与B级、B与C级、C与A级之间的差异均有显著性(P<0.05)，其中A与B级、C与A级之间的差异有极显著性(P<0.01);ALB均值在各级之间的差异均有极显著性(P<0.01);GLB在各级之间的差异均无显著性(P>0.05).
, 百拇医药
结论:在乙型肝炎肝硬化并腹水患者中，按Child-Pugh肝功能评分法评分并分级后，常用生化指标敏感性从高到低依次为TBA、TBIL、ALB、AST、ALT，血清AST及TBA数值与肝功能分级有良好的相关性.
赖力英, 杨旭, 龚国忠, 蒋永芳, 邹文. 乙型肝炎肝硬化并腹水患者肝功能评估时的部分相关因素分析. 世界华人消化杂志 2005;13(6):799-803
Li CP, Lee FY, Hwang SJ, Lu RH, Lee WP, Chao Y, Wang SS, Chang FY, Whang-Peng J, Lee SD. Spider angiomas in
patients with liver cirrhosis: role of vascular endothelial growth factor and basic fibroblast growth factor.
, 百拇医药
World J Gastroenterol 2003;9:2832-2835
3 Giannini E, Botta F, Testa E, Romagnoli P, Polegato S, Malfatti F, Fumagalli A, Chiarbonello B, Risso D, Testa R. The
1-year and 3-month prognostic utility of the AST/ALT ratio and model for end-stage liver disease score in patients
with viral liver cirrhosis. Am J Gastroenterol 2002;97:2855-2860
4 Pohl A, Behling C, Oliver D, Kilani M, Monson P, Hassanein T. Serum aminotransferase levels and platelet counts
, 百拇医药
as predictors of degree of fibrosis in chronic hepatitis C virus infection. Am J Gastroenterol 2001;96:3142-3146
5 Khokhar N. Serum aminotransferase levels and platelet count as predictive factor of fibrosis and cirrhosis in patients
with chronic hepatitis C infection. J Pak Med Assoc 2003;53:101-410
6 Giannini E, Risso D, Botta F, Chiarbonello B, Fasoli A, Malfatti F, Romagnoli P, Testa E, Ceppa P, Testa R. Validity and
, http://www.100md.com
clinical utility of the aspartate aminotransferase-alanine aminotransferase ratio in assessing disease severity and
prognosis in patients with hepatitis C virus-related chronic liver disease. Arch Intern Med 2003;163:218-224
7 中华医学会传染病与寄生虫病学分会、肝病学分会联合修订. 病毒性肝炎防治方案.
中华肝脏病杂志 2000;8:324-329
8 Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding
, http://www.100md.com
oesophageal varices. Br J Surg 1973;60:646-649
9 Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients
undergoing transjugular intrahepatic portosystemic shunts. Hepatology 2000;31:864-871
10 Peng Y, Li C, Chen G, Tang C, Tang S, Li Y. A clinical analysis of alcoholic liver cirrhosis in South Sichuan area.
, 百拇医药
Zhonghua Ganzangbing Zazhi 2002;10:408-412
11 Cai WM, Tao J, Weng HL, Liu RH. Study on the influence factors of the serum fibrosis markers.
Zhonghua Ganzangbing Zazhi 2003;11:23-25
12 Salen G, Batta AK. Bile acid abnormalities in cholestatic liver diseases. Gastroenterol Clin North Am
1999;28:173-193
13 De Almeida JM, Leite-Mor MM, Parise ER. Serum concentration of bile acids in the diagnosis of chronic liver disease
, 百拇医药
and in the functional staging. Arq Gastroenterol 1998;35:81-88
14 Testa R, Valente U, Risso D, Caglieris S, Giannini E, Fasoli A, Botta F, Dardano G, Lantieri PB, Celle G. Can the MEGX
test and serum bile acids improve the prognostic ability of Child-Pugh's score in liver cirrhosis?
Eur J Gastroenterol Hepatol 1999;11:559-563
15 Yang X, Lei J, Zhang Y, Tang X, Zheng Y, Chen J. The diagnostic value and limitations of total serum bile acid
determined enzymatically. Zhonghua Neike Zazhi 2001;40:16-18
编辑 张海宁, http://www.100md.com( 赖力英,杨 旭,龚国忠, 蒋永芳,邹 文)
