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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:

30

期数:

2006年第2期

页码:

107-109

栏目:

体外分析

出版日期:

1900-01-01

文章信息/Info

Title:

A meaningful appraisal of cholestasis in serum total bilirubin,cholyglycine,alphafetoprotein and carbohydrate antigen 19-9

作者:

刘钺;  张朝明;  郝玲;  王荣生

610072 成都, 成都中医药大学附属医院核医学科

Author(s):

LIU Yue;  ZHANG Chao-ming;  HAO Ling;  WANG Rong-sheng

Department of Nuclear Medicine, The Teaching Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China

关键词:

胆汁淤积; 胆红素; 甘氨胆酸; 甲胎蛋白类; 糖类抗原19-9

Keywords:

Cholestasis; Bilirubin; Cholylgycine; Alpha-fetoprotein; Carbohy drate antigen

分类号:

R442.4

摘要:

目的 通过联合检测血清总胆红素(TB)、甘氨胆酸(CG)、甲胎蛋白(AFP)、糖类抗原19-9(CA19-9)在病程中的浓度变化,评价其在肝内胆汁淤滞病理转归过程中的临床意义。方法 分别对96例慢性病毒性肝炎、26例肝硬化(按肝内胆汁淤滞情况分组)及14例肝癌、50例正常对照的血清样本采用生化方法检测TB,放免法测定CG,电化学发光法测定AFP、CA19-9。结果 血清TB在无肝内胆汁淤滞组与对照组及胆汁淤滞无体征组间无显著差异;对照组与胆汁淤滞无体征组间存在显著性差异;胆汁淤滞有体征组、肝硬化组与无肝内胆汁淤滞组、对照组及胆汁淤滞无体征组存在显著性差异(P<0.01)。肝内胆汁淤滞各组血清CG较无肝内胆汁淤滞组及对照组均显示出显著的差异(P<0.01),无肝内胆汁淤滞组与对照组间也显示出显著性差异(P<0.01);肝内胆汁淤滞各组CA19-9与无肝内胆汁淤滞肝组存在显著性差异(P<0.01);肝癌组AFP、CA19-9也明显高于各组(P<0.1)。结论 临床上胆红素是反映胆汁淤滞的粗略指标,对不同状况的胆汁淤滞判断分型困难;在早期发生肝内胆汁淤滞时CG就表现出显著升高,提示肝内胆汁淤滞,CG与肝脏损伤具有很好的相关性,是较为敏感的肝功指标;AFP反映了肝细胞的坏死再生情况,对胆汁淤滞严重程度有警示意义;CA19-9是胆道肿瘤标志物,初步观察发现其增高与淤滞程度具有相关性。

Abstract:

Objective Appraise the clinical signification how the serum total bilirubin (TB), cholylglycine(CG), α-fetoprotein (AFP), carbohydrate antigen 19-9(CA 19-9) have their concentration changes in the pathological changes of intrahepatic cholestasis through a combined detection to them.Methods The serum samples from 96 cases of chronic virus hepatitis, 26 cases of liver cirrhosis and 50 cases of normal people were detected by biochemistry for TB, by radioimmunoassay for CG, by eletro-chemilumineseence for AFP and CA19-9.Results There is no obvious deference of serum TB in the group without intrahepatic cholestasis, the group of cholestasis without clinical symptoms and the control group. There is also a marked deference (P<0.01) in the group of cholestasis with clinical symptoms, the group of liver cirrhosis, the group without intrahepatic cholestasis, the control group and the group of cholestasis without clinical symptoms. The serum CG from the groups of intrahepatic cholestasis, the group without intrahepatic cholestasis, and the control group all show a very obvious deference (P<0.01). The serum CA19-9 from the groups of intrahepatie cholestasis and the group without intrahepatic cholestasis show an obvious deference. The serum AFP, CA19-9 from the group of liver cancer show a very obvious deference (P<0.0).Conclusions In clinc bilirubin is a rough index to reflect cholestasis. It has its own limit in deciding patterns of deferent bile obstruction. In the early stage of intrahepatic cholestasis, that the index of CG is high obviously points out existence of intrahepatic cholestasis. CG and the liver impairment are well interrelated and they are comparatively sensitive indexes of liver function. AFP reflects the regeneration of the liver cell necrosis and it means alarm to the seriousness of intrahepatic cholestasis. CA19-9 is a marker of tumor of biliary tract. The index increase through an initial observation is interrelated to the seriousness of intrahepatic cholestasis.

备注/Memo

备注/Memo:

收稿日期:2005-09-02。
通讯作者:刘钺(E-mail:liuyue289@126.com)

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更新日期/Last Update: 1900-01-01