肝硬化患者血清视黄醇结合蛋白与前白蛋白变化及其临床意义

目的 探讨肝硬化患者血清视黄醇结合蛋白(RBP)、前白蛋白(PAB)的变化,以判定肝脏的合成功能及临床意义.方法 116例肝硬化患者按Child Pugh分级标准分为三组:①A组(A级):17例;②B组(B级):42例;③C组(C级):52例;对照组:50例.均采用自动生化分析仪分别测定血清RBP、PAB、血清白蛋白(ALB)的含量,了解其变化趋势及其灵敏度.结果 A组与对照组比较ALB、PAB两项指标差异无显著性意义,但RBP下降与比较差异有统计学意义(F=2.98,P＜0.05).随肝硬化Child-pugh分级的增加,B、C两组与正常对照组之间三项指标差异均有显著性意义,RBP、PAB在B组即具有差异高度显著性意义(F=14.68,F=7.68,均P＜0.01).血清RBP与PAB呈正相关(r=0.769,P＜0.01),RBP、PAB与ALB之间亦呈正相关(r=0.608,r=0.534,均P＜0.05).结论 随肝硬化Child pugh分级增加,血清RBP及PAB水平均进行性下降,且比ALB更为敏感,两者联合分析能更好的判断肝硬化患者肝功能状况,对患者的预后及治疗提供一定的临床价值.

Changes in serum RBP and PAB levels in patients with cirrhosis

Objective To investigate the changes in serum RBP and PAB levels in patients with cirrhosis and its clinical significance.Methods 116 cirrhotic patients were divided into grade A,grade B and grade C according to the Child Pugh score in ascending order.Control group consisted of 50 healthy subjects.The serum RBP,PAB and ALB concentration was measured with automatic biochemical analyzer.Results RBP concentration was significantly decreased in grade A patients than in control group(F=2.98,P<0.05),while ALB and PAB concentration was not significantly different.There were significant differences in serum RBP,PAB and ALB concentration between Grade B or Grade C and control group.RBP and PAB are more sensitive than ALB.Serum RBP was positively correlated with PAB(r=0.769,P<0.01),serum RBP and PAB were also positively correlated with ALB(r=0.608,r=0.534,P<0.05).Conclusion Serum RBP and PAB progressively decrease with the increase in Child Pugh grade.RBP and PAB are more sensitive than ALB.Combined analysis of RBP and PAB help to determine hepatic function,prognosis and treatment of cirrhotic patients.