多指标联合检测对酒精性肝病的诊断价值探讨

目的 探讨GGT、ALT/AST，红细胞的平均体积（MCV）和最大变形指数（DIMAX）四项指标联合检测对酒精性肝病的诊断价值。方法 对42例酒精性肝病患者，32例其仔肝病患者及56名健康查体者，同时进行GGT、ALT/AST，MCV和DIMAX的检测并进行比较，然后分别计算出单项和四项联合时的阳性率，特异性，阳性预期值，阴性预期值及试验总有效率并加以比较。结果 四指标联合检测的灵敏度为92.9%，特异性为44.6%，阳性预期值为55.7%，阴性预期值为89.2%，实验总有效率为65.3%。结论 四项指标联合检测能提高诊断酒精性肝病的灵敏度。     

王灵台运用大黄治疗慢性肝病的经验

介绍王灵台教授善取大黄为主药治疗慢性肝病的临床经验,即据大黄通降、逐瘀、泄壅、止血等功效合理配伍,辨证分治不同证型的慢性肝病,以提高疗效.     

肝脏病患者血浆内毒素定量检测分析

本文采用鲎变形细胞溶解物（LAL）改良基质显色法对91例肝脏病患者和20例健康对照血浆内毒素进行定量检测。结果，急性肝炎血浆内毒素水平为65．36±30．41ng／L；重症肝炎为161．88±112．88ng／L；慢性活动性肝炎为92．25±56．18ng／L；肝硬化为76．03±46．09ng／L。与正常对照组（5．25±2．90ng／L）相比均显著增高，P＜0．001。各种肝病内毒素阳性率（≥50mg／L）分别为70％、100％、75％、89％．其中重症肝炎内毒素水平明显高于其他肝病组．P＜0．01。表明肝脏病患者大多伴有明显的内毒素血症，血浆内毒素的检出率及浓度与疾病的严重程度及预后有关。     

重症肝病患者人工肝治疗前后凝血功能的变化及临床意义

目的:观察人工肝支持系统(ALSS)对重症肝病患者凝血功能的疗效。方法:30例重症肝病患者在综合疗法的基础上采用人工肝支持系统治疗,通过治疗前后凝血指标的变化,来判断ALSS治疗重症肝病患者的凝血功能的疗效。结果:治疗后凝血酶原时间(PT),部分活化凝血酶原激酶时间(APTT),凝血酶时间(TT),均有不同程度的缩短(P<0.01),纤维蛋白原(Fib)均有不同程度的改善(P<0.05)。结论:检测ALSS治疗的重症肝病患者的凝血指标有助于临床跟踪疗效。     

甘草酸治疗肝病的临床再评价

甘草酸对多种类型肝损伤的防治作用及其机制已在动物实验中得到证明和阐述,具有相当的抗肝炎病毒作用。在临床上,甘草酸用于治疗各种类型的肝病,其中包括治疗重症和急、慢性乙型和丙型病毒性肝炎、化学性(如乙醇性和药物性)肝病及防治肝纤维化。甘草酸能显著增强其他抗病毒药(如阿糖腺苷、拉米夫定或氧化苦参碱等)的抗乙型肝炎病毒作用,联合应用提高治疗慢性乙型病毒性肝炎的疗效。     

The value of anti-rods and rings antibodies in Western China population: A retrospective study

The study aimed to retrospectively investigate the clinical significance of anti-rods and rings (anti-RR) antibodies in antinuclear antibodies (ANAs) test samples of western China. Between January 2016 and November 2018, the laboratory data and clinical details of patients with positive anti-RR antibodies were collected and analysed. The results showed that total of 197 227 patients tested, 109 453 patients presented with positive ANAs (55.50%), but only 107 patients with positive anti-RR antibodies (0.10%), including 51 females and 56 males. Diagnose were established in 51 of 107 patients: 25 were hepatopathy (HCV 8/25, HBV 12/25); 13 were autoimmune diseases (AID); and 7 were renal insufficiency; 6 were chronic obstructive pulmonary disease (COPD). We make the conclusions that anti-RR antibodies have a low prevalence, and there is no gender difference. Anti-RR antibodies exist other diseases besides hepatitis C, such as HBV, some autoimmune diseases, renal insufficiency and COPD, which we need further investigation.     

Epistaxis en el paciente cirrótico: una complicación a tener en cuenta

Introduction

Epistaxis in cirrhotic patients is a common issue. However, the literature published to date is very scarce.

Vibration Controlled Transient Elastography (Fibroscan®) in sickle cell liver disease - could we strike while the liver is hard?

Vibration controlled transient elastography (VCTE) is validated for the evaluation of hepatic fibrosis in different liver diseases. Sickle cell liver disease (SCLD) results from a cumulative hepatic injury and its lifelong and progressive nature raises the need for a non-invasive tool for fibrosis evaluation. Fifty patients, aged between 23 and 59 years with sickle cell disease and suspected SCLD underwent a VCTE followed by a liver biopsy. Biopsies were evaluated for various scores of liver disease that were then correlated to VCTE score. 90% of our patients had an Ishak Fibrosis (IF) score between 0–2 (Group A-minimal to no fibrosis) and 10% of the patients had IF score between 3–6 (Group B-advanced fibrosis). The median Transient Elastography (TE) for patients in Groups A and B was 4·8 kilopascals (kPa) and 17·6 kPa, respectively. A positive correlation was shown between TE and IF score, R = 0·0·68 (P = <0·0001); a positive correlation was also shown with Histology Activity Index fibrosis score, R = 0·64 (P = <0·0001). This study emphasises the need for further studies of non-invasive tools and their utility in liver fibrosis evaluation of patients with SCLD.     

肝病患者凝血、纤溶指标及血小板参数检测的临床意义

目的探讨肝病患者凝血、纤溶指标和血小板参数的变化及其临床意义。方法使用贝克曼ElitePro全自动血凝分析仪和迈瑞BC-5500五分类血细胞分析仪分别检测40例健康体检人员为对照组和90例肝病组的凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(Fib)、D-二聚体,以及血小板计数(PLT)、血小板压积(PCT)、血小板分布宽度(PDW)、血小板分布体积(MPV),并比较。结果与对照组比较,肝硬化、肝癌患者的PT、APTT、TT延长,FIB降低,D-二聚体升高,差异有统计学意义(P<0.05或<0.01)。与代偿期相比,肝硬化失代偿期也存在PT、APTT、TT显著延长,FIB降低,D-dimer升高现象,差异有统计学意义(P<0.05)。与对照组比较,肝硬化失代偿期和原发性肝癌中PLT、PCT显著减少,MPV增大,差异有统计学意义(P<0.05)。结论联合检测肝病患者凝血、纤溶及血小板参数,对病情判断、出血抢救,治疗预后有重要的临床意义。