血清总胆汁酸与传统肝功能酶学指标在肝胆疾病中的比较

目的探讨血清总胆汁酸(TBA)水平在肝硬化、肝癌和梗阻性黄疸中的临床价值。方法采用酶循环法对120例肝胆疾病患者(病例组)和80例健康体检者(健康对照组)进行TBA水平检测,同时检测丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰基转移酶(GGT)的活性,并对检测结果进行比较分析。结果肝硬化组、肝癌组、梗阻性黄疸组血清TBA水平均明显高于健康对照组,差异有统计学意义(P<0.01);并且肝硬化组和梗阻性黄疸组的TBA水平明显高于肝癌组,差异有统计学意义(P<0.01);血清TBA在肝硬化、肝癌及梗阻性黄疸中的阳性率分别为100%、80%、100%,并且明显高于传统肝功能酶学指标,差异有统计学意义(P<0.01)。结论 TBA是反映肝细胞损伤、胆道梗阻的良好指标,其灵敏度、特异性都优于常规肝功能酶学检测项目,对肝胆疾病早期诊断、病情监测具有重要的临床价值。

Comparison of serum total bile acid and conventional indicators of liver enzymes in the disease in liver and gallbladder

Objective To investigate the serum total bile acid（TBA） levels in liver cirrhosis,liver cancer and obstructive jaundice and the clinical value.Methods TBA level was tested in 120 patients with liver and gallbladder disease（case group） and 80 healthy subjects（control group） testing with enzymatic cycling method.The activity of traditional indicators of liver enzyme alanine aminotransferase（ALT）,aspartate acid aminotransferase（AST）,alkaline phosphatase（ALP）,and r glutamyl transferase（GGT） were also tested at the same time,with a comparative analysis of test results.Results Serum TBA level in patients with liver cirrhosis,liver cancer,and obstructive jaundice were significantly higher than that in the control group（P0.01）.And the serum TBA level of patients with liver cirrhosis and obstructive jaundice group were significantly higher than that of patients with liver cancer（P0.01）.The positive rates of serum TBA in patients with cirrhosis,liver cancer and obstructive jaundice were 100%,80%,and 100% respectively.And all were significantly higher than the traditional indicators of liver function enzymes（P0.01）.Conclusion TBA can reflect liver cell injury,and it is a good indicator of biliary obstruction,with sensitivity and specificity,superior to conventional liver enzyme test items for the early diagnosis of liver and gallbladder diseases.It has important clinical value for disease surveillance.