血清前白蛋白测定在肝胆外科疾病中的临床意义

目的探讨肝胆外科病人术前检测血清前白蛋白，白蛋白，总胆汁酸及凝血酶原时间的临床意义。方法将被检者175人分为7组，其中健康对照组25例（A组）；肝内胆管结石25例（B组）；肝硬化门脉高压症25例（C组）；原发性肝癌25例（D组）；肝门部胆管癌25例（E组）；肝脏损伤25例（F组）；急性化脓性胆管炎25例（G组）。所有被检对象均在清晨空腹静脉采血，用ELISA法分别测定PA，ALB TBA及PT。结果在本实验中从B组-G组结果显示，患者血清中前白蛋白逐渐降低（均值（mg／L）A组232．6；B组206．7；C组102．2；D组95．5；E组82．6；F组70．1；G组40．2）。各组与对照组比较，C、D及E组明显下降（P〈0．05），F及G组下降更明显（P〈0．01），肝内外胆管结石无明显下降（P〉0．05）。TBA在C组至G组明显下降（P〈0．05），B组无明显下降（P〉0．05）。而白蛋白、PT在C、D和E组与对照组比较有显著性差异（p〈0．05）。结论血清中前白蛋白含量的改变能敏感、特异、快速反应肝胆外科患者肝脏功能的变化。

The clinical value in the detection of prealbumin for hepatobiliary surgical diseases

Obstrect To investigate the clinical value of prealbiumin（PA）,albiumin（ALB）, total bile acid （TBA）, prothrombin time （PT） in different disease of hepatobiliary surgery. Methods 175 cases were divided into 7 groups including control （group A）, h epatolithiasis（Group B）, portal hypertension （Group C）, hepatocellular carcinoma （Group D ）, carcinoma of bile duct （Group E）, liver injury（Group F）, acute suppurative cholangitis（Group G） There were, 25 cases in each group. The PA, ALB TBA and PT were detected by Elisa method. Results The level of serum prealbiumin reduced gradually from hepatolithiasis to acute suppurative cholangitis. TBA, PT showed significant difference between groupC, D, E and group A. Conclusion the prealbiumin was a indicator of liver function. It＇s sensitivity and specificity are better than those albiumin, TBA and PT.