肝硬化患者肝功能分级及预后判断的实验研究

目的探讨肝硬化患者肝功能分级及预后判断的相关实验项目变化。方法126例不同Child—push分级的肝硬化患者测定血清前白蛋白（PA）、r-谷氨酰转移酶（GGT）、总胆汁酸（TBA）、总胆固醇（Tc）水平及血浆中凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）和纤维蛋白原（FIB）含量。另选取健康体检者80例作为对照同时检测以上八项指标。结果与对照组比较，肝硬化组GGT、TBA血清含量明显升高，PA、TC、FIB含量明显下降，PT、APTT、TT时间延长，差异均有显著性（P〈0．01）；ChildA、B、C三组比较，各项指标均有统计学意义（P〈0．05）。结论联合检测血清PA、GGT、TBA、TC、PT、APTT、TT、FIB对肝硬化患者肝功能的分级，早期诊断及判断预后具有重要价值。

Significance of levels of serum prealbumin,r-glutamyl transferase,total acid,cholesterol and blood coagulation function for the grading of liver function and prognosis of cirrhosis

Aim To establish objective criteria for grading liver function and prognosis of patients with cirrhosis through analyses of serum prealbumin,r-glutamyl transferase,total acid,cholesterol and blood coagulation function. Methods Serum prealbumin（PA ）, r- glutamyl transferase （ GGT ）, total acid （TBA）, cholesterol（TC ） and plasma prothrombin time （PT）, kinase activated partial thmmboplasfin （APTT）,thmmbin time （TT）,fibrinogen （FIB） were measured in 121 patients with liver cirrhosis in different grades of Child-Pugh classification and 80 healthy persons. Results Data were significantly different in patients with liver cirrhosis compared with healthy group：the levels serum GGT,TBA were higher,and the levels of PA, TC, FIB were decreased greatly, the time of PT, APTT, TT times elongated （P〈0.01）;various indicators in group Child A.B. C were statistical significance （P〈0.05）. Conclusion The combined detection of levels of serum PA, GGT, TBA, TC, PT, APTT,TT,FIB in patients with cirrhosis are of great values in liver function classification ,early diagnosis and prognosis.