血清前白蛋白、胆碱酯酶与总胆汁酸检测在肝病临床诊断中的价值

目的探讨病毒性肝病患者血清PA、CHE、TBA的变化及其在临床诊断分型中的意义。方法采用HITACHI-7080型全自动生化分析仪检测65例健康对照者和236例各临床型的病毒性肝病患者的血清PA、CHE、TBA,其分为急性肝炎、慢性肝炎、重型肝炎和肝硬变患者。同时检测白蛋白(ALB)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、r-谷氨酸转肽酶(r-GT或GGT)、总胆红素(TBIL)。结果各组肝病患者的血清PA、CHE明显低于对照组,TBA水平(慢性轻度肝炎组除外)显著高于正常对照组(P<0.05)。慢性肝炎患者血清PA、CHE含量与慢性肝炎发展阶段性相一致,在慢性重度肝炎与肝硬变阶段达最低水平。结论检测血清PA、CHE、TBA三项指标对于病毒性肝病早期诊断、动态观察及预后评估具有一定的理论和临床价值。

Clinic Value of Prealbumin,Cholinesterase and Total Bile Acid in Diagnosing Patients with Liver Disease

Objective To determine the role of prealbumin（PA）, cholinesterase（CHE） and total bile acid （TBA）in diagnosing patients with viral liver disease. Methods Serum level of PA、CHE and TBA were measured by HITACHI-7080 automatic analyzer in 65 healthy controls and 236 patients with acute hepatitis, chronic hepatitis or hepatic cirrhosis. At the same time, ALB, ALT, AST, GGT and TBIL were measured. Results The result showed that the serum levels of PA, CHE of these patients were lower, while the levels of and TBA （excluding patients with light hepatitis）were higher significantly than that of healthy controls（P〈0.05）.The level of the serum PA,CHE in patients with chronic hepatitis was consistent with its development stages, which reached the lowest level at the severe stage of chronic hepatitis and hepatic cirrhosis. Conclusion The measurement of the concentration of serum PA, CHE, TBA is of some theoretic and clinical significance in the dynamic observation of liver fibrosis, the early diagnosis, therapy and the estimate of the prognosis.