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目的检测慢性肝病患者进行血清胆碱酯酶(CHE),观察各临床分型肝病、肝组织炎症分级及肝纤维化分期的血清胆碱酯酶的变化。方法采用丁酰硫代胆碱法对192例慢性肝病患者进行血清CHE活性检测。结果不同临床分型中慢性肝炎轻度CHE(7730.6±852.4)U/L,中度(6587.5±920.0)U/L,重度(5068.9±813.6)U/L,三者与对照组(8520.3±920.6)U/L比较P<0.05;肝硬化CHE(2882.1±810.5)U/L,慢性重型肝炎CHE(2583.2±807.0)U/L,两者与对照组比较P<0.01。肝组织炎症不同分级患者血清CHE分别为G17815.9±925.6,G26888.2±953.4,G35470.6±1088.7,G42604.0±1015.7。G2,G3,G4与G1相比P<0.05;G4与其它组相比P<0.01。肝组织纤维化程度不同分期病人血清CHE分别为S08043.5±985.3,S16888.2±953.4,S25598.7±1054.6,S33841.2±1179.5,S42518.4±1028.9。S2,S3,S4同S0、S1比较P<0.05,S4与各期比较P<0.01。结论血清CHE活性与肝脏病变程度及肝组织病理损害程度呈明显的负相关关系。血清CHE可用于慢性肝病病情严重程度及预后的判断,血清CHE是观察慢性肝病患者肝组织炎症及纤维化变化的较敏感指标。
Objective To detect serum cholinesterase (CHE) in patients with chronic liver disease and observe the changes of serum cholinesterase in various clinical types of liver disease, liver inflammation grade and liver fibrosis staging. Methods Serum CHE activity was measured in 192 patients with chronic liver disease by butyrylcholinesterase method. Results The mild CHE (7730.6 ± 852.4) U / L, moderate (6587.5 ± 920.0) U / L and severe (5068.9 ± 813.6) U / L were significantly different among the three groups (P <0.05); CHE of cirrhosis (2882.1 ± 810.5) U / L and chronic severe hepatitis CHE (2583.2 ± 807.0) U / L, both P <0.01 compared with the control group. Serum levels of CHE in patients with different grades of liver inflammation were G17815.9 ± 925.6, G26888.2 ± 953.4, G35470.6 ± 1088.7 and G42604.0 ± 1015.7, respectively. G2, G3, G4 compared with G1 P <0.05; G4 P <0.01 compared with other groups. The serum levels of CHE in patients with different stages of liver fibrosis were S08043.5 ± 985.3, S16888.2 ± 953.4, S25598.7 ± 1054.6, S33841.2 ± 1179.5, and S42518.4 ± 1028.9, respectively. S2, S3, S4 compared with S0, S1 P <0.05, S4 compared with each phase P <0.01. Conclusions Serum CHE activity has a significant negative correlation with the severity of liver lesions and the degree of liver damage. Serum CHE can be used to judge the severity and prognosis of chronic liver disease. Serum CHE is a sensitive indicator to observe the changes of liver inflammation and fibrosis in patients with chronic liver disease.