• 1. 四川大學(xué)華西醫(yī)院麻醉科(成都610041) ;;
  • 2. 四川大學(xué)華西醫(yī)院普外科(成都610041);

【摘要】目的  探討血清γ-球蛋白在評估肝臟儲備功能中的作用。方法 對30例肝臟腫瘤切除術(shù)的患者術(shù)前進行肝功能分級以及血清蛋白電泳檢查,分析γ-球蛋白與手術(shù)前、后肝功能Child-Pugh分級的關(guān)系,以及用血清γ-球蛋白作為評估標準與肝功能Child-Pugh分級的符合程度。結(jié)果  術(shù)前肝功能Child-Pugh分級A級的26例患者血清γ-球蛋白為(21.053 3±6.001 4)%,明顯低于4例B級患者的(28.800 0±8.672 5)%,差異有統(tǒng)計學(xué)意義(P<0.05); 術(shù)后肝功能Child-Pugh分級A級的25例患者術(shù)前血清γ-球蛋白為(21.022 0±5.354 6)%,明顯低于5例B、C級患者的(29.556 0±7.698 5)%,差異同樣有統(tǒng)計學(xué)意義(P<0.05); 以血清γ-球蛋白 gt;30%作為預(yù)測術(shù)后肝功能代償不良的標準,其敏感性(80.00%)、特異性(96.00%)都較好。結(jié)論  術(shù)前患者血清γ-球蛋白可以反映其肝臟儲備功能,結(jié)合患者術(shù)前血清γ-球蛋白監(jiān)測結(jié)果和肝功能Child-Pugh分級能夠更客觀地評估肝臟占位病變患者肝臟儲備功能情況。

引用本文: 梁鵬 ,尹杰,王璇,曾勇. 血清γ-球蛋白評價肝臟儲備功能的臨床研究. 中國普外基礎(chǔ)與臨床雜志, 2008, 15(4): 274-277. doi: 復(fù)制

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  3. 3.  Caban A, Wiaderkiewicz R, Kamiński M, et al. Arterial ketone index in assessing liver function and its detoxicative capability after ischemia-reperfusion injury [J]. Acta Biochim Pol, 2000; 47(4)∶1137.
  4. 4.  Nagashima I, Takada T, Okinaga K, et al. A scoring system for the assessment of the risk of mortality after partial hepatectomy in patients with chronic liver dysfunction [J]. J Hepatobiliary Pancreat Surg, 2005; 12(1)∶44.
  5. 5.  Poon RT, Fan ST. Assessment of hepatic reserve for indication of hepatic resection: how I do it [J]. J Hepatobiliary Pancreat Surg, 2005; 12(1)∶31.
  6. 6.  嚴律南, 陳曉理, 李志輝, 等. 肝癌肝切除術(shù)圍手術(shù)期處理的臨床研究(附2 143 例報告) [J]. 中國普外基礎(chǔ)與臨床雜志, 2005; 12(2)∶162.
  7. 7.  Li GH, Zhu SL, Li JQ, et al. Evaluation of partial hepatectomy for primary liver carcinoma [J]. J Surg Oncol, 1989; 41(1)∶5.
  8. 8.  Wakabayashi H, Ishimura K, Izuishi K, et al. Evaluation of liver function for hepatic resection for hepatocellular carcinoma in the liver with damaged parenchyma [J]. J Surg Res, 2004; 116(2)∶248.
  9. 9.  李琴, 王寶恩, 賈繼東, 等. 肝功能分級的演變及特點: 從Child到MELD [J]. 中華肝臟病雜志, 2004; 12(5)∶319.
  10. 10.  雷團結(jié), 黎一鳴, 陳域, 等. D-山梨醇肝清除率評估肝儲備功能的臨床研究 [J]. 中國實用外科雜志, 2005; 25(2)∶103.
  11. 11.  彭寶崗, 黃潔夫, 呂明德, 等. 肝功能試驗綜合預(yù)測肝癌病人的肝儲備功能 [J]. 中山醫(yī)科大學(xué)學(xué)報, 1995; 16(2)∶44.
  12. 12.  呂明德, 黃潔夫, 彭寶崗, 等. 多因素分析兩步判別法預(yù)測肝功能儲備力 [J]. 中華外科雜志, 1994; 32(12)∶745.
  13. 13.  Maruyama S, Hirayama C, Horie Y, et al. Serum immunoglobulins in patients with chronic hepatitis C: a surrogate marker of disease severity and treatment outcome [J]. Hepatogastroenterology, 2007; 54(74)∶493.
  14. 14.  Fernandez FJ, Rivas G, Salgado J, et al. Comparative evaluation of serum protein analysis by capillary zone electrophoresis and agarose gel electrophoresis [J]. Am Clin Lab, 2002; 21(4)∶26.
  15. 15.  王庸晉. 現(xiàn)代臨床檢驗學(xué) [M]. 第2版. 北京: 人民軍醫(yī)出版社, 2000∶272.
  16. 16.  O’Connell TX, Horita TJ, Kasravi B. Understanding and interpreting serum protein electrophoresis [J]. Am Fam Physician, 2005; 71(1)∶105.