血清γ-球蛋白与Child-Pugh肝功能分级在肝脏储备功能评估中的价值

目的探讨血清γ-球蛋白与Child-Pugh肝功能分级在术前评估肝脏储备功能的价值。方法选取我院72例肝癌肝切除病人和12例终末期肝病行肝移植病人为研究对象,测定手术前后血清γ-球蛋白的水平、肝硬化百分比、Child-Pugh肝功能分级,用统计学方法分析三指标之间的关系。结果血清γ-球蛋白测定值与纤维化百分比呈直线相关趋势（r=0.862,P〈0.001）;随着肝功能级别的升高,肝纤维化面积百分比逐级随肝功能损害加重而升高,在Child-Pugh A、B、C三者间,两两比较亦有显著差异（P〈0.05）;术后Child-Pugh分级下降的患者术前的血清γ-球蛋白明显高于术前同一级别的患者,差别有统计学意义（P〈0.05）。结论血清γ-球蛋白检测可作为临床术前评价肝脏储备功能的手段之一,并且可以弥补Child-Pugh肝功能分级的不足。

Clinical significance of serum gamma globulin for the evaluation of preoperative hepatic functional reservation

Objective To investigate the serum γ-globulin and Child-Pugh classification of liver function in the preoperative evaluation of liver functional reserve value.Methods 72 patients with liver cancer and 12 patients with end stage liver disease for the study of liver transplant patients were recruited.The levels of serum γ-globulin,the percentage of cirrhosis,Child-Pugh classification of liver function were measured before and after operation.Results The serum γ-globulin was a linear correlation with the trend of the percentage fibrosis（r=0.862,P0.001） and with the increased levels of liver function.Liver fibrosis percentage progressively increased with the rise of liver function damage.Child-Pugh classification in patients with preoperative decrease of serum γ-globulin was significantly higher than that before operation（P0.05）.Conclusion Serum γ-globulin can be used as clinical preoperative evaluation of liver functional reserve one of the means,and can make up for Child-Pugh classification of liver function deficiency.