血清总胆汁酸对肝硬化患者肝功能的评价

目的探讨肝硬化病人血清胆汁酸增高的临床意义。方法选取我院92例住院肝硬化病人，采用Child-pugh计分法分为Child-pughA级（41例）、B级（44例）和C级（18例），分析他们的血清胆汁酸、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、谷氨酰转肽酶（GGT）、碱性磷酸酶（ALP）、总胆红素（TBIL）的变化情况。结果血清胆汁酸在肝硬化病人中显著异常，异常率82．6％，高于ALT（58．7％）、AST（69．6％）、GGT（58．49％）与ALP（41．3％）。且不同Child—pugh分级肝硬化病人TBA亦相差显著，肝功能分级越差的病人，其TBA越高。结论血清胆汁酸的测定更能及早反映肝细胞的损伤和灵敏反映毛细胆管排泌胆汁障碍，这对预测及判断肝硬化预后及病情的严重程度有重要意义。

Evaluation of Fasting Serum Total Bile Acid to the Hepatic Function of the Patients with Liver Cirrhosis

Objective To observe the role of the fastings serum Total bile acid(sTBA) in evaluating the hepatic functions of patients with liver cirrhos.Methods Ninety-two patients with liver cirrhosis were divided into three groups according to Child-pugh score classification.Analyze and compare the changes of levels of their total bile acid,ALT,AST,GGT,ALP,TBIL.Results Level of serum total bile acid in patients with liver cirrhosis was notable abnormal and the abnormal rate was 82.6%;it was higher and earlier than that of alanine aminotransferase(58.7%),glutamyl transferase(58.49%),alkaline phosphatase(41.3%).And sTBA was different in different ratings cirrhosis of the child-pugh patient,the more bad liver function ratings was,the higher sTBA was.Conclusions The level of total bile acid can express the impairment of hepatocyte and the obstacle of capillary biliation early and sensitively.