236例肝病和上消化道出血患者血氨浓度检测结果分析

目的用单波长反射测试法检测肝病患者的血氨浓度并进行分析。方法采用日本PocketChemTMBA（PA-4130）血氨检测仪测定236例患者的血氨浓度。结果236例肝病和上消化道出血患者血氨浓度升高者153例,占64.83%。其中慢性病毒性肝炎增高例数占63.16%,血氨平均值为51.16μmol/L;肝硬化增高例数占74.03%,平均值79.05μmol/L;失代偿肝硬化患者增高例数占73.33%,平均值为84.80μmol/L;重症肝炎增高例数80.00%,血氨平均值为94.60μmol/L;肝癌增高例数占37.84%,血氨平均值51.64μmol/L;肝性脑病增高例数占83.33%,血氨平均值为97.66μmol/L;上消化道出血患者血氨浓度值超过正常范围占52.78%,平均值为56.80μmol/L。结论血氨的动态监测可以作为判断和估测重症肝炎、肝硬化、肝癌及肝性脑病严重程度和预后的一个重要生物学指标,上消化道出血病人也可导致血氨升高,出现氨中毒现象。单波长反射测试方法简便、快速、准确、适用于临床分析。

Clinical analysis of the determination of blood ammonia concentration in 236 patients with liver disease and upper gastrointestinal hemorrhage

Objective To determine and analyze the blood ammonia concentrations in patients of liver disease by single wavelength reflection test.Methods The blood ammonia concentrations in 236 patients of liver disease were measured using blood ammonia meter pocketChem BA PA-4130.Results The blood ammonia levels in 64.83%（153/206）） hepatopathology and upper respitaory bleeding cases were elevated including 12 of the 19 cases with chronic viral hepatitis（63.16%,with the average blood ammonia level of 51.16 μmol/L）.The average blood ammonia level was increased（79.05 μmol/L） in 74.03%（57/77） hepatic cirrhosis cases.The average blood ammonia level（84.80 μmol/L） was incereased in 73.33% of decompensated cirrhosis cases.The average blood ammonia level（94.60 μmol/L） was increased in 80.00% ofsevere hepatitis cases（8/10）.The average blood ammonia level（51.64 μmol/L） was increased in 37.84% of the hepatocarcinoma cases（14/37）,the average blood ammonia level（97.66 μmol/L） was inceased in 83.33%（10/12） of hepatic encephalopathy cases.The average blood amonnia level in 19 of the 36 upper gastrointestinal bleeding cases was also increased in 52.78%,with the average blood ammonia level of 56.80μmol/L.Conclusion Determaniation of blood ammonia levels can be used as an important biological indicator for evaluating the severity and prognosis of severe hepatitis,hepatic cirrhosis,hepatocarcinoma,hepatic encephalopathy as well as upper gastrointestinal bleeding,thus it is useful for clinical application