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目的探讨胆碱酯酶(CHE)和总胆汁酸(TBA)检测在肝脏疾病诊断中的临床价值。方法选取2013年2月至2014年10月就诊于广州医科大学附属肿瘤医院肝病科的患者186例,其中急性病毒性肝炎50例,慢性活动性肝炎45例,肝硬化57例,肝癌34例。同期选取健康体检者50名作为对照组。检测5组参与者血清CHE及TBA水平。结果4组肝病患者的血清CHE水平均显著低于对照组,TBA浓度明显高于对照组,差异均有统计学意义(均P<0.05);肝癌、肝硬化患者血清CHE水平显著低于肝炎患者,TBA浓度高于急性病毒性肝炎组,差异均有统计学意义(均P<0.05);肝硬化及肝癌患者的CHE检测阳性率均显著高于急性病毒性肝炎组,TBA检测阳性率均显著低于急性病毒性肝炎、慢性活动性肝炎组,差异均有统计学意义(均P<0.05)。结论 TBA检测对肝病诊断阳性率较高,但CHE检测对肝硬化、肝癌的检出率较高,联合检测CHE和TBA指标对诊断肝病价值更高。
Objective To investigate the clinical value of detecting cholinesterase (CHE) and total bile acid (TBA) in the diagnosis of liver diseases. Methods A total of 186 patients were enrolled in the Department of Hepatology, Cancer Hospital Affiliated to Guangzhou Medical University from February 2013 to October 2014. Among them, there were 50 cases of acute viral hepatitis, 45 cases of chronic active hepatitis, 57 cases of liver cirrhosis and 34 cases of liver cancer. In the same period, 50 healthy people were selected as the control group. Serum CHE and TBA levels were measured in 5 participants. Results The levels of serum CHE in patients with liver disease were significantly lower than those in the control group (P <0.05). The levels of serum CHE in patients with liver cancer and cirrhosis were significantly lower than those in patients with hepatitis (P <0.05). The positive rate of CHE in cirrhosis and hepatocellular carcinoma patients was significantly higher than that of acute viral hepatitis group, and the positive rate of TBA was significantly higher than that in acute viral hepatitis group Lower than acute viral hepatitis, chronic active hepatitis group, the difference was statistically significant (P <0.05). Conclusion The positive rate of TBA detection in diagnosis of liver disease is high. However, the detection rate of CHE in cirrhosis and liver cancer is higher, and the combined detection of CHE and TBA is more valuable for the diagnosis of liver disease.