血清前白蛋白预测原发性肝癌患者肝储备功能的价值

目的探讨血清前白蛋白（Prealbumin，PA）在原发性肝癌（Primary Liver Carcinoma，PLC）患者围手术期肝储备功能预测中的临床价值。方法回顾性分析128例在我院接受肝癌切除术的PLC患者围手术期血清PA水平与肝功能Child—pugh分级及术后肝功能衰竭的关系。结果术前Child—pugh分级A级患者的血清PA水平（182．6±45．1）mg／L]明显高于B级患者（137．1±35．5）mg／L]，差异具有统计学意义（P〈0．01）。术后第1天血清PA水平开始下降，第5天降至最低谷，以后逐渐回升，到术后2w时基本恢复到术前水平；术后第1、3、5、7天时血清PA、TBili、ALT、AST的异常率均明显高于血清Alb的异常率（P〈0．05）。术后发生肝功能衰竭的患者术后第1、3、5、7天的血清PA水平均低于未发生肝功能衰竭的患者，尤以术后第5、7天更为明显（P〈0．01）。结论血清PA可以敏感地反映PLC患者的肝功能损害程度和肝储备能力，术后动态观察血清PA水平的变化可及时发现肝功能衰竭，并可作为患者预后判断的参考依据。

THE FORECAST VALUE OF SERUM PREALBUMIN FOR LIVER RESERVE FUNCTION OF PATIENTS WITH PRIMARY LIVER CARCINOMA

Objective To investigate of the clinical forecast value of prealbumin for liver reserve function of patients with primary liver carcinoma（PLC） in perioperative period, netilods One hundred and twenty -eight serum samples from patients with PLC who accept the resection of liver cancer in our hospital were retrospectively analyzed to reveal the relationship between PA and Child - pugh grade, postoperative liver failure in perioperative period. Results The serum value of PA in patients of Child -Pugh A grade （182.6 ± 45.1 m）g/L] apparently higher than Child -Pugh B grade （ 137.1 ± 35.5 ） mg/L], which were statistically significant（p 〈0. 01 ）. The serum value of PA began to fall from the first postoperative day, fell to the bottom at the fifth day and then picked up gradually, basically returned to preoperative levels until to the postoperative 2 w. The abnormal rate of serum PA ,TBili ,ALT,AST were significantly higher than the serum Alb（p 〈 0. 05 ） at the first, third, fifth, seventh postoperative day. The serum value of PA of the liver failure patients are less than that for the patients who didn＇t occur liver failure at the first, third, fifth, seventh postoperative day, especially at the fifth, seventh postoperative day （p 〈 0. 01 ）. Conclusion The serum value of PA can sensitively and exactly reflect the reserve ability and damage degree in patients with PLC, dynamic observation of the changes of serum PA level after operation can discover the liver failure timely, which can be used as a reference for patients prognosis judgment.