慢性肝病患者血清甲胎蛋白等指标检测的临床分析

目的探讨甲胎蛋白（AFP）、糖类抗原125（CA125）、糖类抗原199（CA199）、胆碱酯酶（CHE）检测在慢性乙型肝炎及肝硬化患者中的临床意义。方法检测62例慢性乙型肝炎患者,50例肝硬化患者（其中肝硬化代偿32例,失代偿18例）血清AFP、CA125、CA199、CHE水平,另设24例健康对照者。结果慢性乙型肝炎患者血清AFP较健康对照组轻中度升高,差异有统计学意义（P〈0.05）。肝硬化患者血清AFP较健康对照组显著升高,其中肝硬化失代偿组较代偿组升高明显。CA125在慢性乙型肝炎患者血清中无明显升高,但在肝硬化特别是失代偿伴腹腔积液者明显升高。CA199在慢性乙型肝炎及肝硬化患者均有升高,并随病情发展有升高趋势。慢性乙型肝炎患者血清CHE轻度降低,肝硬化患者血清CHE显著降低,指标越低病情越严重。结论 AFP在慢性乙型肝炎及肝硬化患者血清有升高,可以作为肝脏受损的参考指标,监测病情。CA125在肝硬化失代偿时明显升高,对判断肝硬化患者有无腹腔积液有一定的临床意义。CA199可用于评判慢性肝病的病情进展。CHE对慢性肝病的病情判断及预后有一定的临床意义。

Clinical analysis of AFP,CA125,CA199,CHE in chronic hepatitis B and hepatocirrhosis

Objective To discuss the change of levels of AFP,CA125,CA199,CHE in serum of chronic hepatitis B and hepatocirrhosis.Methods AFP,CA125,CA199,CHE were analyzed in 62 patients with chronic hepatitis B,50 patients with hepatocirrhosis（including 32 patients without ascites and 18 patients with ascites）,and 24 healthy controls.Results The AFP levels in serum of chronic hepatitis B was statistically higher than these of the healthy control group,especially in patients with hepatocirrhosis,AFP levels of hepatocirrhosis decompensation patients were higher than compensation patients.The CA125 levels of chronic hepatitisB were not obviously higher than these of the healthy control group,especially in patients with ascites.CA199 levels of chronic hepatitisB and hepatocirrhosis were higher than these of the healthy control group.The trend was upwards with the progress of the disease.The CHE levels decreased slightly in chronic hepatitis B patients and decreased markedly in hepatocirrhosis,the lower the levels was,the more serious illness would be.Conclusion The AFP increasing in chronic hepatitis B and hepatocirrhosis can be used as a consulting factor of the injury of liver.The CA125 levels rising in hepatocirrhosis of decompensation has great relationship with ascites.CA199 may be used to evaluate the progression of chronic liver diseases.The CHE levels can be certain significant for judging chronic liver disease and prognosis.