肝炎后肝硬化患者血清总胆汁酸及肝纤维化指标与child—pugh分级关系

目的：探讨肝炎后肝硬化患者不同child—pugh分级与血清总胆汁酸（TBA）和肝纤维化指标血清Ⅳ胶原（Ⅳ．C）、血清透明质酸（HA）及B超肝纤维化参数积分的相互关系。方法：对肝炎后肝硬化患者依child—pugh分级，测定TBA、HA、Ⅳ．C以及B超肝纤维化参数积分。结果：child-pugh分级A、B、C三组TBA分别为9．00±4．40μmol／L、21．43±14．18μmoL／L、46．27±29．78μmol／L，HA分另4为313．20±104．59ng／ml、366．37±158．46ng/ml、527．00±157．29ng／ml，Ⅳ-C分别为238．05±36．68ng／ml、355．63±27．43ng／ml、493．97±109．58ng／ml，B超积分分别为10．70±3．76分、13．10±3．50分、14．50±3．12分。随肝硬化肝功能受损程度加重，各指标数值逐渐增加，差异有显著性意义（P〈0．05），且TBA、IV—C、HA、B超积分诸项指标相互均有相关性（P〈0．05）。结论：四项指标相互间具有相关性，是判断肝炎后肝硬化严重程度的有用指标。

Relation of Total Serum Bile Acid and Indexes of Liver Fibrosis to the Child-Pugh Grading

Objective：To study the possible relationship of the level of total serum bile acid （TBA） and liver fibrosis indexes including serum IV collagen （ IV-C ） , hyaluronic acid （ HA ） , and liver fibrosis scoring by ultrasound to different Child-Pugh grades in patients with HBV-related cirrhosis. Methods：Patients with HBV-related cirrhosis were divided into A,B,and C groups according to the Child-Pugh grades. TBA, HA, and IV-C were tested and liver fibrosis scores were measured by ultrasound. Results： n the A, B, and C groups, TBA was （9.00 4.40） , （21.43 ± 14. 18 ） , and （46.27 ± 29.78） μmol/L,HA was （313.20 ± 104.59）, （366.37 ± 158.46） ,and （527.00 ± 157.29） ng/ml,Ⅳ-C was （238.05 ± 36.68 ） , （355.63 ± 27.43 ） , and （ 493.97 ± 109.58 ） ng/ml, and liver fibrosis score was （ 10.70 ± 3.76 ） , （ 13.10 ± 3.50）, and（ 14.50 ± 3.12）, respectively. The levels of these indexes were elevated as the increase of the severity of liver cirrhosis and the difference in each index was statistically significant within each group（ P 〈 0.05 ）. The indexes themselves were interrelated （ P 〈 0.05 ）. Conclusion ： TBA, HA,Ⅳ-C, and ultrasound scores were correlated and they are useful markers to diagnose the severity of HBV-related liver cirrhosis.