血清胆碱酯酶与慢性肝病临床和病理的相关性

目的检测慢性肝病患者进行血清胆碱酯酶（CHE）,观察各临床分型肝病、肝组织炎症分级及肝纤维化分期的血清胆碱酯酶的变化。方法采用丁酰硫代胆碱法对192例慢性肝病患者进行血清CHE活性检测。结果不同临床分型中慢性肝炎轻度CHE（7730.6±852.4）U/L,中度（6587.5±920.0）U/L,重度（5068.9±813.6）U/L,三者与对照组（8520.3±920.6）U/L比较P〈0.05;肝硬化CHE（2882.1±810.5）U/L,慢性重型肝炎CHE（2583.2±807.0）U/L,两者与对照组比较P〈0.01。肝组织炎症不同分级患者血清CHE分别为G17815.9±925.6,G26888.2±953.4,G35470.6±1088.7,G42604.0±1015.7。G2,G3,G4与G1相比P〈0.05;G4与其它组相比P〈0.01。肝组织纤维化程度不同分期病人血清CHE分别为S08043.5±985.3,S16888.2±953.4,S25598.7±1054.6,S33841.2±1179.5,S42518.4±1028.9。S2,S3,S4同S0、S1比较P〈0.05,S4与各期比较P〈0.01。结论血清CHE活性与肝脏病变程度及肝组织病理损害程度呈明显的负相关关系。血清CHE可用于慢性肝病病情严重程度及预后的判断,血清CHE是观察慢性肝病患者肝组织炎症及纤维化变化的较敏感指标。

Correlation of level of cholinesterase with pathology of chronic hepatic disease

Aim To investigate the correlation of levels of cholinesterase with the pathology of chronic hepatic disease.Methods The activity of cholinesterase in serum of 192 chronic hepatic disease patients were determined.Results The levels of cholinesterase in light,intermediate and heavy chronic hepatic disease cases of different clinial phases were7730.6± 852.4U/L,6587.5 ±920.0U/L and 5068.9 ±813.6U/L,respectively,showing significant differences as compared with the controls（8520.3±920.6U/L）（P0.05）.While the levels of cholinesterase in cirosis and healvy hepatic disease cases were 2882.1±810.5U/L and 2583.2±807.0U/L,also showing significant differences as compared to the controls（P0.01）.The levels of cholinesterase chronic heaptic disease cases at various grades of inflammation of heptic tissues were also significantly different（P0.01）,being 7815.9±925.6,6888.2±953.4,5470.6±1088.7 and 2604.0±1015.7 from grade 1 to grade 4,showing significant differences among different grades（P0.05 and P0.01）.The concentrations of cholinesterase in hepatic disease cases with various greade of fibrosis of liver tissues were 8043.5 ±985.3,6888.2 ±953.4,5598.7 ±1054.6,3841.2 ± 1179.5 and 2518.4±1028.9 from stage 0 to stage 4,also showing significant differences among different stages（P0.05）and P 0.01）.Conclusion The activity of cholinesterase is inversly correlated with the grade,stage and severity of inflammation and fibrosis of hepatic tissues.Thus the level of cholinesterase can be used as the relatively sensitive indicator for evaluation of severity of inflammation and fibrosis of hepatic tissues in chronic hepatic disease patients.