胆碱酯酶在乙肝肝硬化患者肝脏储备功能的评估应用

目的:研究胆碱酯酶(CHE)在评估乙肝肝硬化患者肝脏储备功能中的应用价值。方法:收集501例肝硬化患者病例,并根据肝脏功能进行Child分级。应用全动自动生化分析仪,以酶速率比色法检测胆碱酯酶(CHE),溴甲酚绿法检测白蛋白(ALB),凝固法检测凝血酶原时间(PTs)。应用方差分析,研究胆碱酯酶(CHE)在不同CHILD分级组别中的肝功能评价意义。应用相关分析方法,比较胆碱酯酶(CHE)与其他肝脏合成指标白蛋白(ALB)、凝血酶原时间(PTs)的相关性。结果:肝硬化患者在严格Child-Pugh分级标准划分而成的ABC三级中,各级胆碱酯酶(CHE)活性逐级明显下降,分别为5469.04±1777.31 U/L(Child A),2935.08±1206.95 U/L(Child B),1810.40±724.72 U/L(Child C),且结果差异有显著意义(F=261.114,P=0.000)。在肝硬化患者中,胆碱酯酶(CHE)与白蛋白(ALB)总体正相关、与凝血酶原时间(PTs)总体负相关。其中Child A级患者中,CHE与ALB成正相关,与PTs负相关。Child B级患者中,CHE与PTs负相关,但与ALB无显著相关性。Child C级患者中,CHE与ALB正相关,但与PTs无显著相关性。结论:胆碱酯酶(CHE)与肝硬化患者肝细胞损害的严重程度相关,可反映肝脏的储备功能,与白蛋白(ALB)、凝血酶原时间(PTs)有同样重要的价值。

The Practical Value of Cholinesterase in Evaluating Liver Reserve Function of Cirrhosis Patients Due to Hepatitis Virus B

Objective: To observe the practicing value of cholinesterase in evaluating liver reserve function of cirrhosis patients due to hepatitis virus B.Methods: 501 cirrhosis patients due to hepatitis virus B were divide into three groups according to Child score.Serum cholinesterase of the patients were detected with enzyme rate method;Meanwhile,serum albumin was detected with Bromcresol green test and serum plasma prothrombin time was detected with clotting assay.Using analysis of variance(ANOV),the practicing value of cholinesterase were analyed in evaluating liver reserve function of cirrhosis patients in defferent Child grades.Using analysis of correlation,the correction bewteen cholinesterase and albumin and serum plasma prothrombin time were analyed.Results: The patients of cirrhosis were strictly into A,B and C grades according to the modified Child score.The results showed that cholinesterase trended to significantly decrease in the three grades Child A(5469.04±1777.31 U/L),Child B(2935.08±1206.95 U/L) and Child C(1810.40±724.72 U/L)(F=261.114,P=0.000.Basicly in the patients of cirrhosis,cholinesterase was positively correlated with albumin,and negatively correlated with serum plasma prothrombin time.In Child A grade,cholinesterase was also positively correlated with albumin and negatively correlated with serum plasma prothrombin time.In Child B grade,cholinesterase was still negatively correlated with serum plasma prothrombin time,but there was no significant correlation bewteen it and albumin.In Child C grade,cholinesterase positively correlated with albumin,but there was no significant correlation bewteen it and serum plasma prothrombin time.Conclusion: Related with the damage severity of liver cells,cholinesterase can response to the liver reserve function.