血浆胆碱酯酶、凝血酶原活动度及清蛋白在病毒性肝炎中的临床应用

目的研究血浆胆碱酯酶(CHE)、清蛋白(ALB)及凝血酶原活动度(PTA)与病毒性肝炎临床分型、病情及预后之间的关系。方法采用速率法检测162例不同临床分型病毒性肝炎患者及40例健康对照组CHE,同时分别采用终点法和比浊法测定ALB及PTA。结果急性病毒性肝炎、慢性病毒性肝炎、肝炎后肝硬化及重型肝炎组血浆CHE、ALB、PTA水平依次降低,显著低于健康对照组(P<0.001)。随肝脏炎症和纤维化程度的加重,各项指标均逐渐下降,差异有显著性(P<0.001)。各组CHE活力较PTA、ALB下降的百分率更高,差异有显著性(P<0.001)。CHE、ALB及PTA彼此间相关系数为0.695~0.811(P<0.001),呈正相关。结论血浆CHE活力较ALB、PTA能更好地反映肝脏的合成功能和储备能力。监测CHE、ALB和PTA,对临床病情的判断及估计预后有着重要意义。

Clinical Application of Plasma Cholinesterase, Prothrombin Activity and Albumin in Patients with Viral Hepatitis

Objective To investigate the relationship between the level of cholinesterase(CHE)and albumin(ALB)in plasma and the prothrombin activity(PTA)and the clinical type,disease condition and prognosis in the viral hepatitis patients.Methods Plasma CHE,ALB and PTA were detected in162patients with the different clinical type viral hepatitis and40healthy individuals with enzyme rate method,ending reaction methods and turbidimetry test respectively.Results The level of CHE,ALB and PTA decreased gradually in acute hepatitis,chronic hepatitis and cirrhosis,and was significantly compared with the control group(P<0.001).The level of plasma cholinesterase,albumin and plasma prothrombin activity decreased gradually followed by the exacerbation of inflammatory reaction and by the elevation of degree of fibrosis of the liver(P<0.001).The percentage decreased in the level of plasma cholinesterase was higher than that of albumin and plasma prothrombin activity in each viral hepatitis patients group(P<0.001).There was a positive correlation and the correlation coefficient was0.695to0.811(P<0.001).Conclusions The level of CHE can reflect the synthetic function more sensitively than ALB and PTA.The investigation of plasma CHE,ALB and PTA level are very helpful to the diagnosis and prognosis valuation of severe hepatitis.