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肝硬化Child-Pugh评分的相关因素分析
Studies on relevant gactors of Child-Pugh grading in hepatic cirrhosis
文章发布日期:2011年03月15日  来源:  作者:袁继丽 刘成海 赵长青  点击次数:7990次  下载次数:1567次
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【摘要】:目的 探讨肝硬化患者Child-Pugh评分与肝脏合成功能[胆碱酯酶(ChE)、凝血酶原时间(PT)]、肾功能[血清胱抑素(CysC)、肌酐(Cr)、尿素氮(BUN)]、血清钙和磷水平的相关性。方法 回顾性分析179例肝硬化患者的Child-Pugh分级及肝肾功能、血清钙、磷水平的关系,按Child分级分为A、B、C三组, Child不同分级间生化指标的比较采用方差分析和S-N-K检验。Child评分与各生化指标间的相关性采用双侧Pearson相关分析,各生化指标对Child评分的影响作用采用多元回归分析方法。结果 随着Child评分的升高,肝硬化患者的ChE下降、PT升高, A、B、C三组间差异具有统计学意义(P<0.05); BUN、Cr呈升高趋势,A、C两组间具有统计学差异(P<0.05);B、C组间BUN差异有统计学意义(P<0.05)。Child分级 A、B、C三组肝硬化患者的Cys、钙、磷无明显变化。相关分析显示,Child评分与年龄、PT、BUN、Cr正相关,与ChE呈负相关(P<0.05)。多元回归分析显示,ChE、PT对于Child评分有明显影响作用。结论 肝硬化不同Child-Pugh分级中ChE、PT、Cr、BUN出现明显变化。其中,血清ChE对于Child评分有明显的影响作用,是判断肝脏疾病严重程度的重要参考依据。
【Abstract】:Objective To investigate the correlation of Cholinesterase (ChE), prothrombin time (PT), Serum Cystatin C (CysC ), serum creatinine (Cr), blood urea nitrogen (BUN), serum calcium (Ca2+) and serum phosphorus (P) with different Child-Pugh classification in hepatic cirrhosis patients. Methods In 179 hepatic cirrhosis patients with different Child-Pugh classification, serum ChE, PT, CysC, Cr, BUN, Ca2+ and P were retrospectively analyzed. And their clinical significance was appraised with Pearson correlation analysis and Multinomial logistic regression analysis. Results erum ChE and Ca2+remarkablely declined and PT increased with increases grading of Child-pugh classification (P<0.05); CysC and Cr increased gradually having a significant difference between Child A group vs Child C group (P<0.05); Bun increased gradually with a significant difference between the two groups Child A group vs Child C group and Child B group vs Child C group (P<0.05). There was no difference in P in all groups. Pearson correlation analysis showed that age, PT, BUN and Cr were positively correlated with Child-Pugh grading, and that ChE was negatively correlated with it. Multinomial logistic regression analysis showed that factors influencing Child-Pugh included CHE and PT. Conclusions Serum ChE, CysC, BUN, Cr and Ca2+ changed with different Child-Pugh classification. Serum ChE had important guiding value on the clinical assessment of liver diseaseseverity.
【关键字】:肝硬化;胆碱酯酶类;半胱氨酸蛋白酶抑制剂
【Key words】:liver cirrhosis; cholinesterases; cysteine proteinase inhibitors
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