重癥肺炎是造成重癥加強(qiáng)治療病房（ICU）患者死亡的主要原因之一[1]。前白蛋白（PA）是肝臟合成的負(fù)性急性時(shí)相蛋白，半衰期短，能準(zhǔn)確地反映肝臟損害的程度，但在評(píng)價(jià)患者預(yù)后及嚴(yán)重性方面還存在有爭(zhēng)議[2，3]。故此，本研究通過動(dòng)態(tài)觀測(cè)重癥肺炎患者PA變化，探討其與病情嚴(yán)重程度及預(yù)后的關(guān)系。
摘要:目的: 探討血清前白蛋白(prealbumin,PAB)、膽堿脂酶(cholinesterase,ChE)、總膽汁酸(total bile acid,TBA)在肝硬化中的檢測(cè)價(jià)值。 方法 :測(cè)定105例肝硬化患者和30例健康人的前白蛋白、膽堿脂酶、總膽汁酸活性及肝功能生化指標(biāo),并按ChildPugh分級(jí)進(jìn)行比較。 結(jié)果 :肝硬化組前白蛋白含量、膽堿脂酶活性均較對(duì)照組顯著降低;按ChildPugh分級(jí)比較,肝硬化組前白蛋白含量在Child A級(jí)與對(duì)照組、B級(jí)與A級(jí)之間、在C級(jí)與B級(jí)之間差異有顯著性(Plt;001);膽堿脂酶活性在Child A級(jí)與對(duì)照組、B級(jí)與A級(jí)、C級(jí)與B級(jí)之間差異有顯著性(Plt;001)?？偰懼嵩贑hild B級(jí)與A級(jí),C級(jí)與B級(jí)間有顯著差異性,在A級(jí)與對(duì)照組間差異無(wú)顯著性。 結(jié)論 :血清前白蛋白、膽堿脂酶在肝硬化早期評(píng)估中有很重要的價(jià)值,而總膽汁酸在肝硬化預(yù)后的判定中有重要價(jià)值。 Abstract: Objective: To evaluate the role of prealbumin (PAB), cholinesterase (ChE), and total bile acid (TBA) in evaluating liver reserve function in patients with liver cirrhosis. Methods : One hundred and five serum samples from patients with liver cirrhosis were detected in PAB, ChE, TBA and other biochemical markers. All patients were classified in accordance with ChildPugh scale. Results : For PAB, the differences among ChildPugh A, B, C and healthy group were statistically significant (t=1254, 1887, 2316) (Plt;001). For ChE, the differences among ChildPugh A, B, C and healthy group were statistically significant (t=1288, 0856, 1002) (Plt;001). For TBA, the differences among ChildPugh C group, B group and A group were statistically significant (t=0526, 1081)(Plt;001), the difference among ChildPugh A group and healthy group was not statistically significant (t=5615) (Pgt;005). Conclusion : PAB and ChE reflect liver reserve function earlier in patients with liver cirrhosis. The role of TBA is important in reflecting prognosis in patients with liver cirrhosis.