乙型肝炎患者血清钙水平及其与临床的关系分析

目的:比较各临床类型乙型肝炎患者的血清钙水平,探讨其与主要肝功能指标和血清尿素氮(BUN)水平的关系.方法:收集湘雅二医院传染科同日测定的439例乙型肝炎患者血清钙水平和主要肝功能指标及BUN检测资料,比较各型患者血清钙水平和异常血钙发生情况,并分析血钙与肝功能指标和BUN的相关性.结果:乙型肝炎病例低钙发生率较高,特别是重型肝炎和肝硬化患者平均血钙水平低,易发生低血钙.血钙水平与ALT和TBil无统计学相关性,但慢性肝炎、重型肝炎和肝硬化患者血钙水平与血清Alb水平呈统计学正相关,慢性重度患者血钙水平与PT负相关.肝硬化患者血钙水平还与BUN负相关.低蛋白血症和PT延长的病例伴有低血钙较常见.结论:乙型肝炎患者特别是重型肝炎和肝硬化患者易发生低血钙,血钙水平与肝功能状态和BUN有一定相关性,低蛋白血症和PT延长的病例应注意低血钙的发生.

Analysis of Serum Calcium Level in Hepatitis B Patients and Its Relationship with Clinical Characteristics

Objective:To compare serum calcium levels in different clinical types of hepatitis B patients, and to explore its relationships with liver function indices or blood urea nitrogen(BUN) level.Methods:Data of 439 patients inflicted with hepatitis B in the Infectious Disease Department of Second Xiangya Hospital, whose serum calcium concentration and main liver function indices were assayed on the same day, were collected. Levels of serum calcium, incidences of abnormal serum calcium in different types of hepatitis B, were compared.The correlation between serum calcium and main liver function indices and BUN level were analyzed. Results:Hepatitis B patients have high hypocalcemia incidence. Serum calcium concentration in patients with severe hepatitis or cirrhosis was especially lower, and these patients are prone to hypocalcemia. Serum calcium was not statistically correlated with ALT, TBil.But it was significantly and positively correlated with Alb in patients of chronic hepatitis, severe hepatitis and cirrhosis,and negatively correlated with PT in chronic severe hepatitis B patients. Besides, it was negatively correlated with BUN in cirrhosis.Patients with hypoproteinemia or prolonged prothrombin time(PT) were often accompanied by hypocalcemia.Conclusion:Hepatitis B patients, especially severe hepatitis and cirrhosis patients,were prone to hypocalcemia.Serum calcium level was,to some extent, correlated with some liver function indices and BUN level. More attention should be paid to patients with hypoproteinemia or prolonged PT to prevent hypocalcemia.