血清总胆固醇及总胆汁酸检测对肝病诊断的临床意义

目的探讨肝病患者血清总胆固醇（TC）、总胆汁酸（TBA）检测的临床意义。方法选择2012年2月至2013年10月在该院确诊为肝硬化的86例患者设为肝硬化组,确诊为肝癌的84例患者设为肝癌组,另选择80例同期健康体检者设为对照组,检测血清TC与TBA水平,对三组检测结果进行统计学分析。结果与对照组比较,肝硬化组和肝癌组血清TC水平明显降低,差异有统计学意义（P〈0.05）,而TBA水平明显升高,差异有统计学意义（P〈0.05）;在肝硬化组Child-Pugh分级中,C级患者的血清TC水平最低,分别与A级和B级两两比较,差异均有统计学意义（P〈0.05）,但A级与B级比较,差异无统计学意义（P〉0.05）;血清TBA在肝硬化组的A、B、C级中两两比较,差异均有统计学意义（P〈0.05）,且其水平随着肝功能Child-Pugh分级的增高而升高。结论肝病患者TC、TBA水平均能敏感反映肝损伤的进展情况,是诊断肝病的良好指标,2项指标联合检测可以提高肝硬化疾病的灵敏度,降低漏诊率。

Clinical significance of serum TC and TBA detection for diagnosis of hepatopathy

Objective To explore the clinical significance of the detection of serum total choesterol（TC） and total bile acid（TBA） for hepatopath. Methods A total of 86 patients,who were diagnosed with cirrhosis from February 2012 to October2013,were selected as cirrhosis group,simultaneously,other 84 patients diagnosed with liver cancer were taken as cancer group,and other 70 healthy subjects were chosen as control group. To detect the levels of serum TC and TBA,and the results of the three groups were analyzed statistically. Results Compared with the control group,the serum TC level reduced apparently in both cirrhosis group and cancer group with statistically significant difference（P〈0.05）,but serum TBA level increased obviously with statistically significant difference（P〈0.05）. According to Child-Pugh classification in cirrhosis group,the serum TC in the patients with Grade C was the lowest,which compared with the Grade A and Grade B respectively,the differenced showed statistical significance（P〈0.05）,but the difference between Grade A and Grade B had no statistical significance（P〈0.05）;moreover,pairwise com panison of serum TBA level among Grade A,Grade B and Grade C in cirrhosis group had statistically significant difference（P〈0.05）,and the level of serum TBA showed upward tendency with the increase of Child-Pugh classification. Conclusion The levels of TBA and TC in hepatopathy are helpful to reflect the state of liver damage,they are both good indicators for diagnosis of liver disease,in addition,the joint detection of TC and TBA can improve the sensitivity of cirrhosis,reduce the rate of missed diagnosis.