肝硬化患者血清总胆汁酸测定的临床意义

目的 探讨肝硬化患者血清总胆汁酸测定的临床意义.方法 75例肝硬化患者Child-Pugh分级,A级28例,B级31例,C级16例,检测血清总胆汁酸水平,与49例正常体检者进行组间比较.结果 肝硬化各级(组)血清总胆汁酸水平均明显高于正常对照组(P<0.01),且其增高程度随Child-Pugh分级差异而不同.结论 总胆汁酸是评价肝硬化患者肝功能的重要指标.与Child-Pugh分级密切相关.     

肝硬化患者中血清总胆汁酸测定的临床意义

背景：胆汁酸在肝内合成和分泌，因此可以作为反映肝细胞损害的指标之一。目的：探讨肝硬化患者血清总胆汁酸（TBA）测定的临床意义。方法：收集42例肝硬化患者的肝功能资料，比较TBA与其他常规肝功能指标的敏感性差异。结果：肝硬化组的TBA显著高于健康对照组（P＜0．01），其水平为健康对照组的6．9倍，异常率为74％，显著高于丙氨酸转氨酶（ALT）、γ－谷氨酰转移酶（γ－GT）和碱性磷酸酶（ALP）（P＜0．01）。肝硬化失代偿期患者的TBA水平显著高于代偿期患者（P＜0．01）。结论：TBA是反映肝硬化患者肝细胞损害的敏感指标之一。     

肝硬化患者血清脂蛋白和总胆汁酸水平分析

目的探讨肝硬化患者血清脂蛋白、载脂蛋白和TBA水平的变化。方法检测109例肝硬化患者和40例正常献血员血清HDL、LDL、VLDL、ApoA1、ApoB100和TBA水平。结果肝硬化患者HDL、LDL和ApoAl与TBA水平呈负相关（r=-0．488,-0．521,-0．564,P〈0．01）,而VLDL与TBA水平呈正相关（r=0．622,P〈0．01）;肝硬化患者血清HDL、LDL和ApoA1水平均明显低于对照组（P〈0．01）,VLDL明显高于对照组（P〈O．01）,且随着肝功能分级的变差,血清HDL、LDL和ApoA1水平逐渐下降,而VLDL和TBA水平逐渐升高（P〈0．01）。结论肝硬化患者存在脂质代谢异常,注意血清脂蛋白和TBA水平变化有助于对患者病情的判断。     

肝硬化患者血清胆固醇、胆碱酯酶、总胆汁酸的变化及临床意义探讨

目的探讨肝硬化患者血清总胆固醇(Tch)、胆碱酯酶(ChE)、总胆汁酸(TBA)变化的临床意义。方法检测92例肝硬化患者及68例健康者的Tch、ChE及TBA水平。结果肝硬化组Tch、ChE水平低于对照组(P<0.05),TBA水平显著高于对照组(P<0.01),Tch、ChE在肝功能Child-Pugh分级C级中最低,TBA在C级中最高,与A级和B级相比存在显著性差异(P<0.01)。结论血清Tch、ChE、TBA能较准确地提示肝细胞的损害程度,判断肝硬化病情,估计预后。     

检测肝硬化患者血清前白蛋白和总胆汁酸水平的临床意义

目的　探讨肝硬化患者血清前白蛋白 (PA)与总胆汁酸 (TBA)水平关系及其变化的临床意义。方法　用日本产CL 72 0 0全自动生化分析仪分别检测 10 2例肝硬化患者及 3 0例正常献血员血清PA、TBA水平。结果　肝硬化患者血清PA明显低于正常对照组 (P <0 .0 1) ,TBA明显高于正常对照组 (P <0 .0 1) ,且随肝功能损伤程度的加重PA值逐渐下降 ,TBA值逐渐升高 ;肝硬化患者血清PA与TBA水平呈明显负相关 (r =-0 .682 ,P <0 .0 1)。结论　肝硬化患者存在血清PA水平下降 ,TBA水平升高 ,血清PA与TBA呈明显负相关 ,联合检测血清PA、TBA水平能较早地反映肝脏合成及其代谢功能 ,对病情和预后的早期判断有重要的临床价值     

肝硬化患者血清脂蛋白、载脂蛋白与总胆汁酸水平分析

本文对109例肝硬化患者检测血清高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、极低密度脂蛋白（VLDL）、载脂蛋白A1（ApoA1）、载脂蛋白B100（ApoB100）及总胆汁酸TBA水平,并进行相关研究。     

空腹血清总胆汁酸对肝硬化患者肝功能的评价

目的观察空腹血清总胆汁酸(sTBA)对肝硬化患者肝功能的评价作用.方法采用Child-pugh计分法对临床诊断为肝硬化的103例病人分为C hild-pugh A级(41例)、B级(44例)和C级(18例).所有病人取空腹血,酶免法测sTBA,比较不同Child-pugh分级肝硬化病人sTBA水平.同时测定所有病人血清中丙氨酸转氨酶(ALT), 并作对比分析.结果肝硬化患者sTBA水平明显高于非肝病对照组(54.8 ±37.5 μmol/L VS 12.6±9.1 μmol/L,P＜0.05);且不同child-pugh分级肝硬化病人sTBA亦相差显著,肝功能分级越差的病人,其sTBA越高.除Child-pugh C级血清ALT 与其它两组相差显著外(P＜0.05),Child-pugh A级与B级间无显著差异(P＞0.0 5).结论空腹sTBA不但是区分肝脏病与非肝脏病的良好生化指标,同时也是反映肝硬化肝功能状态的良好指标之一.     

肝硬化联合检测总胆汁酸、透明质酸的意义

目的:探索血清总胆汁酸(TBA)及透明质酸(HA)与肝硬化的关系。方法:本文检测了96例肝硬化及28例正常人的血清、腹水中的总胆汁酸(TBA)及透明质酸(HA)浓度。结果:各类肝硬化血清及腹水的总胆汁酸及透明质酸浓度均明显高于正常对照组(P<0.01)。且不同类型的肝硬化之间也有差异。结论:总胆汁酸是一种较灵敏的肝功能指标,尤其是在肝功能常规指标改变不明显时,对肝硬化的诊断有一定的价值。透明质酸能够较好地反映肝纤维增生情况,是一个良好的肝纤维化血清学诊断指标。也是反映肝硬化程度及预后的客观指标。     

老年肝硬化患者血清总胆汁酸及血清前白蛋白含量变化及临床意义

目的：探讨老年肝硬化患血清总胆汁酸（TBA）及血清前白蛋白（S－pA)含量变化及临床意义。方法：测定59例老年肝硬化组及23例青年肝硬化对照组和50例正常老年对照组的血清总胆汁酸含量及血清前白蛋白的水平,进行统计学分析,结果：老年肝硬化组血清TBA浓度明显高于正常老年组（P＜0．01）。老年肝硬化组血清TBA随肝功能损害程度的加重而升高,Child-pughC级较C级较B级和A级明显升高。而老年肝硬化患血清前白明显下降,Child-pughC分组中A－C级呈递减趋势,结论：老年肝硬患TBA水平与肝硬化的肝功能密相关。．与青年肝硬化对照组相比无明显差异（P＞0．05）。检测TBA水平与肝硬化功能密切相关,与青年肝硬化对照组相比无明显差异,检测TBA有利临床评估肝硬化病情及预后,另外,血清前白蛋白对临床评估肝硬化患的病情也有一定价值。     

血清总胆汁酸测定在肝硬化临床诊断中的价值

血清总胆汁酸(TBA)分析正逐渐成为肝病患者肝功能受损和病情进展的有用指标[1].为了探讨血清TBA测定在老年肝硬化临床诊断中的应用价值,本研究回顾性分析了2010年3月至2012年3月112例老年肝硬化患者的临床资料及血清TBA检测结果,并与青年肝硬化患者进行对比研究. 1资料与方法 1.1 一般资料选择2010年3月至2012年3月在我院接受诊治的老年肝炎肝硬化患者112例,其中男82例,女30例;年龄60 ～ 79[平均(69.10 ±9.03)]岁;选择同期在我院接受诊治的青年肝炎肝硬化患者100例,其中男74例,女26例;年龄30～51[平均(39.85 ±9.11)]岁.112例老年肝炎肝硬化患者按照Child-Pugh分级,其中A级39例,B级42例,C级31例.     

Urinary bile acid sulfate levels in patients with primary biliary cirrhosis

Aim: Urinary bile acids are mainly conjugated with sulfuric acid. In a previous work, we demonstrated that the levels of urinary sulfated bile acids (USBA) and serum total bile acids (TBA) were correlated very well and also that USBA was considered to be a more useful indicator of hepatic fibrosis than TBA in patients with hepatitis C virus (HCV)‐related liver diseases. In the current study we aimed to confirm these finding in patients with primary biliary cirrhosis (PBC), a prototypic cholestatic liver disease. Methods: Urinary sulfated bile acids were measured using an automatic assay kit in 50 patients with PBC, of whom 11 were diagnosed as having cirrhosis. We obtained specimens before ursodeoxycholic acid (UDCA) administration in four patients, and during UDCA in 46 patients. The correlations between USBA and various laboratory tests were studied. Results: The median USBA level was 67.9 µmol/g creatinine in PBC; 27.7 without cirrhosis and 210.3 with cirrhosis (P = 0.001). The number of PBC patients with elevated USBA was significantly higher than those with elevated TBA (82% vs. 56%). This significance was remarkable especially in early stages, non‐cirrhotic patients (77% vs. 49%). USBA level was well correlated with TBA (r_s = 0.72), and negatively correlated with platelet (r_s = ?0.34) and albumin (r_s = ?0.31). Conclusion: Urinary sulfated bile acids and TBA are well correlated, and together with the findings that USBA is not affected by meals, USBA is considered to be more beneficial and convenient than TBA for earlier detection of fibrosis in PBC.     

慢性病毒性肝炎血清总胆汁酸与肝组织细胞成分变化的相关性研究

目的探讨血清总胆汁酸（TBA）与慢性病毒性肝炎肝组织细胞成分变化的关系。方法对134例慢性病毒性肝炎患者做肝穿刺活检及检测血清TBA,应用病理图像分析仪以点计数法测量肝组织400倍镜视野内的主要细胞成分,测量内容包括良好肝细胞、变性肝细胞、纤维组织、脂肪细胞、淋巴细胞,计算各种组分的均数及密度。根据TBA水平的不同,将病人分成两组,比较两组病人之间五种肝组织细胞成分的差异,并使用多元线性逐步回归分析TBA升高者与肝组织细胞成分数密度的相关性。结果 （1）TBA升高组较TBA正常组的肝组织中良好肝细胞显著减少,变性肝细胞、纤维组织、脂肪细胞、淋巴细胞显著增多,差异有统计学意义（P〈0.005）。（2）TBA与变性肝细胞、肝纤维化、淋巴细胞数密度成正相关,相关系数分别为0.433、0.367、0.494,与良好肝细胞、脂肪细胞无统计学相关。结论 TBA升高与淋巴细胞数密度的相关性最密切,TBA升高可能具有间接或直接反映慢性病毒性肝炎患者肝组织的细胞免疫状态。     

慢性肝炎肝组织病理改变与血清总胆汁酸关系探讨

目的 研究空腹血清总胆汁酸(TBA)与血清纤维化指标的关系，阐明其临床意义。方法 收集慢性肝病患者73例，肝组织活检当天行血清TBA及HA检测，并分析其相关性。结果 慢性肝炎患者TBA水平与正常值相比明显升高，与肝组织炎症活动(G)、纤维化程度(S)及血清纤维化指标(HA)呈正相关，相关系数r分别为0．515、0．430、0．687。结论 TBA是反映肝脏炎性活动及肝纤维化的较敏感指标。     

血清总胆汁酸测定的意义及其局限性

目的　阐明空腹血清总胆汁酸（TBA）测定的临床意义。方法　收集913例临床资料,用SPSS软件及四格表法进行统计分析。结果　（1）正常人TBA平均（4.0±3.2）μmol/L。肝病组TBA显著高于正常人和非肝病组(P＜0.01)。（2）急性肝炎患者TBA平均为（167.2±132.4）μmol/L,最高达449.5μmol/L,与其他各组相比差异有显著性(P＜0.01),表明TBA是反映急性肝细胞损伤的敏感指标。（3）TBA对肝硬化的敏感性为85.8%,优于其他肝功能试验,TBA是反映肝硬化侧支循环的有价值的指标。（4）TBA对慢性轻度肝炎的敏感性仅为30.5%,不及ALT和总胆红素（TBIL）。（5）TBA水平与病情轻重有一定关系,但与TBIL不完全平行,对病情的判断不如TBIL有价值。结论　TBA特异性高,敏感性尚可,对肝病、特别是急性肝炎和肝硬化有重要诊断价值,但对慢性轻度肝炎的敏感性差,对病情的判断不如TBIL有意义。     

血清总胆汁酸在婴幼儿巨细胞病毒肝炎中的动态变化及临床意义

目的:探讨血清总胆汁酸(TBA)在巨细胞病毒(CMV)肝炎患儿中的动态变化和临床诊疗价值．方法:对21例CMV肝炎患儿血清TBA按照初次就诊时、入院后治疗前、治疗2 wk后、出院时进行动态检测,并与ALT和AST作比较．结果:21例CMV肝炎患儿入院治疗前TBA阳性率高于ATL阳性率(100％vs 80．9％,P<0．01):入院治疗前TBA>80μmol／L组预后不良发生率明显大于TBA≤80μmol／L组(75％vs 23．1％,P<0．01)．结论:TBA是诊断婴幼儿CMV肝炎的敏感指标,其动态检测对指导临床治疗、反映病变程度和预后判断有一定临床参考价值．     

血清胆碱酯酶和总胆汁酸与慢性乙型肝炎患者肝脏病理损害的关系探讨

目的探讨血清胆碱酯酶（CHE）、总胆汁酸（TBA）与慢性乙型肝炎肝脏病理损害的关系。方法检测303例经肝穿刺活检病理证实的慢性乙型肝炎患者血清CHE和TBA，并对其与肝活检组织病理炎症分级和纤维化分期进行相关性分析。结果随着肝脏病理炎症分级和纤维化分期的加重，血清CHE逐渐下降，而血清TBA逐渐升高。血清CHE与肝脏病理分级和分期呈显著负相关（P〈0．01），血清TBA与肝脏病理分级和分期呈显著正相关（P〈0．01）。结论临床上联合测定血清CHE和TBA可在一定程度上反映慢性乙型肝炎肝组织病理损伤的程度。     

肝硬化患者红细胞变形性及能量代谢的变化

观察肝硬化患者红细胞变形性（ED）、红细胞能量代谢和血氧变化。以红细胞AP和2.3-二磷酸甘油酸（2.3-DPG）含量作为衡量红细胞能量代谢状态的指标，对32例且硬化患者取血动态观察其ED、ATP和2.3-DPG含量、PaO2和SaO2的变化并与正常人比较。肝硬化患者的ED、PaO2和SaO2明显降低，2.3-DPG含量明显增高；并发肝性脑病（HE）时PaO2明显降低，ATP及2.3-DPG含量明显减少。肝硬化患者的ED明显降低并伴有低氧血症；红细胞能量代谢降低与HE的发生有关。     

胆囊切除后粪胆汁酸代谢状况的研究

目的探讨胆囊切除后粪胆汁酸的代谢变化。方法利用薄层层析方法,检测了40例胆囊切除后病人和16例正常人粪胆酸(CA)、鹅脱氧胆酸(CDCA)、脱氧胆酸(DCA)和石胆酸(LCA)的浓度。结果胆囊切除后 CA、LCA 明显高于对照组(P<0.01)。同时,石胆酸与脱氧胆酸的比值(LCA/DCA)也显著高于对照组(P<0.01)。结论胆囊切除后存在胆汁的代谢紊乱,粪胆汁酸浓度升高可能为胆囊切除后患结肠癌危险性增加的原因之一。     

Differences in the efficacy of ursodeoxycholic acid and bile acid metabolism between viral liver diseases and primary biliary cirrhosis

AIM AND METHODS: The effects of ursodeoxycholic acid (UDCA, 600 mg/day) on liver function test values, and serum and urinary bile acids levels in hepatitis C virus-related chronic hepatitis (CH, n = 39) and liver cirrhosis (LC, n = 25), and in primary biliary cirrhosis (PBC, n = 25) were compared. RESULTS: The percentages of improvement in alanine transaminase (ALT) and gamma-glutamyl transpeptidase (gamma-GTP) in CH were almost the same in LC. The rates of improvement in ALT in PBC were negatively correlated with histological stages in the liver. Total serum bile acid levels in LC rose to the same extent as in CH, but the increases in PBC were significantly smaller at stages 3-4 than stages 1-2. The urinary levels of hydroxylated metabolites of UDCA only slightly increased in LC, but they increased significantly at PBC stages 3-4. CONCLUSIONS: The efficacy of UDCA was preserved in LC, but diminished at PBC stages 3-4. The poor enrichment of UDCA in the bile acid pool and extensive biotransformation of UDCA may cause the limited efficacy of UDCA in the cirrhotic stage of PBC.     

Urinary bile acid sulfate levels in patients with hepatitis C virus-related chronic liver diseases

Aim:  Urinary bile acids are mainly conjugated with sulfuric acid, and urinary sulfated bile acid (USBA) levels in hepatobiliary diseases have been reported. However, the relationship between USBA and fasting serum total bile acid (TBA) has not been studied in hepatobiliary diseases. In the present study, we measured USBA levels in patients with hepatitis C virus-related chronic liver diseases, and the relationship between TBA and various laboratory tests was studied.
Methods:  USBA was measured using an automatic assay kit in 66 patients with chronic hepatitis and 28 patients with liver cirrhosis, and its relationship between TBA and various laboratory tests was studied.
Results:  The median USBA level was 10.7 µmol/g creatinine in patients with chronic hepatitis and 41.1 µmol/g creatinine in liver cirrhosis ( P  = 0.000). More patients with chronic hepatitis had elevated USBA levels (61%) compared to TBA level (39%) ( P  = 0.002). USBA level was well correlated with TBA (r_s = 0.680), and negatively correlated with albumin (r_s = −0.488), prothrombin time (r_s = −0.385) and platelet counts (r_s = −0.394). In patients with liver cirrhosis, USBA was significantly elevated in Child–Pugh class B compared to Child–Pugh class A ( P  = 0.036).
Conclusion:  Although the metabolic pathways of USBA and TBA are different, these levels correlated very well, and USBA is considered to be a useful indicator of hepatic function like TBA in patients with chronic hepatitis C.