胆碱脂酶、胆汁酸及全血细胞计数与慢性乙型肝炎病理变化的关系探讨

目的探讨慢性乙型肝炎患者血清胆碱酯酶（CHE）、总胆汁酸（TBA）及全血细胞计数血小板计数2（/中性粒细胞百分比×单核细胞百分比,PLT2/MN）]的变化及其与肝脏炎症分级及纤维化分期之间的相关性。方法检测325例经肝活检检查的慢性乙型肝炎患者血清CHE、TBA及PLT2/MN比值的变化,并分析它们与肝组织的炎症分级和纤维化分期的相关性。结果肝组织炎症分级G0～G2、G2～G3和G3～G4及纤维化分期S0～S2、S2～S3和S3～S4之间CHE、TBA及PLT2/MN比值均有显著性差异（P〈0.01）。CHE及PLT2/MN比值与炎症分级和纤维化分期呈负相关,而TBA与之呈正相关。结论CHE、TBA及PLT2/MN比值能较好地反映慢性乙型肝炎患者肝组织的炎症活动和纤维化程度,三个指标在一定程度上可以提示早期肝硬化。

Changes of serum levels of cholinesterase,total bile acid and PLT2/MN ratio were related to hepatic inflam matory and fibrosis in patients with chronic hepatitis B

Objective To study the correlation between the serum levels of cholinesterase （CHE）,total bile acid （TBA）and PLT^2/MN ratio to the severity of liver injuries in patients with chronic hepatitis B. Methods Serum levels of CHE,TBA and PLT^2/MN ratio were detected or calculated in 325 patients with biopsy-proven hepatitis B. Results The serum CHE,TBA levels and PLT^2/MN ratio in patients with G0-G2,G2-G3 and G3-C,4 or S0-S2,S2-S3 and S3-S4 were significantly different. CHE levels and PLT^2/MN ratio decreased,hut serum levels of TBA increased as the inflammatory grading and fibrosis staging developed. Conclusion Combined determination of CHE,TBA and PLT^2/MN ratio might prodiet the degree of inflammatory process and hepatic fibrosis in patients with hepatitis B.