肝硬化患者血清CA125水平與Child-Pugh分級(jí)、CHE及腹水量相關(guān)性分析

黃喜岷，邱建國，洪睿珂(.成都市西區(qū)醫(yī)院普外科，四川成都60036；.四川大學(xué)華西醫(yī)院肝膽胰外科，四川成都6004)

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肝硬化患者血清CA125水平與Child-Pugh分級(jí)、CHE及腹水量相關(guān)性分析

黃喜岷1，邱建國2，洪睿珂1
(1.成都市西區(qū)醫(yī)院普外科，四川成都610036；2.四川大學(xué)華西醫(yī)院肝膽胰外科，四川成都610041)

[摘 要]目的 探討肝硬化患者血清CA125水平與Child-Pugh分級(jí)、CHE及腹水量的相關(guān)性。方法 選擇2013年10月至2014年12月我院收治的82例肝硬化患者為研究對(duì)象，分別按Child-Pugh分級(jí)、腹水量分組，另外選取同期40例健康體檢者為對(duì)照組，采用電化學(xué)發(fā)光法、速率法檢測血清CA125、CHE水平，Spearman相關(guān)分析CA125與Child-Pugh分級(jí)、CHE及腹水量的相關(guān)性。結(jié)果 CA125水平:Child C級(jí)患者＞Child B級(jí)＞Child A級(jí)，三組比較具有統(tǒng)計(jì)學(xué)意義(P＜0.05)，大量腹水組＞中量腹水組＞少量腹水組＞無腹水組(P＜0.05)。CHE水平:Child C級(jí)患者＜Child B級(jí)＜Child A級(jí)，三組比較具有統(tǒng)計(jì)學(xué)意義(P＜0.05)。CA125與CHE呈負(fù)相關(guān)(r=-0.599，P＜0.05)，與Child-Pugh分級(jí)呈正相關(guān)(r=0.736，P＜0.05)，與腹水量呈正相關(guān)(r=0.779，P＜0.05)。結(jié)論 肝硬化患者血清CA125與有無腹水、肝功能損傷程度、CHE有關(guān)，血清CA125、CHE的監(jiān)測可能對(duì)評(píng)估肝硬化患者的病情有一定的價(jià)值。

[關(guān)鍵詞]肝硬化；糖抗原125；Child-Pugh分級(jí)；血清膽堿酯酶

Correlation analysis of serum CA125 level between Child-Pugh classi■cation, CHE and volume of ascites in patients with cirrhosis HUANG Xi-min1, QIU Jian-guo2, HONG Rui-ke1.1Department of General Surgery, Chengdu Western Hospital, Chengdu 610036, China;2Department of Hepatobiliary and Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China

Abstract ObjectiveTo explore the correlation of serum CA125 levels between Child-Pugh classi■cation, CHE and volume of ascites in patients with cirrhosis.MethodsA total of 82 patients with liver cirrhosis from Oct.2013 to Dec.2014 in our hospital were selected.They were divided into different groups according to Child-Pugh classi■cation and ascites.Another 40 healthy were selected as control group.CA125 level was detected with ECL assay, CHE levels was detected using the rate assay.The correlation of CA125 and Child-Pugh classi■cation, CHE and ascites was analyzed.ResultsCA125 levels in different groups were Child C group ＞ Child B group ＞ Child A group, the differences in three groups were statistically signi■cant (P＜0.05)； massive ascites group ＞ moderate amount of ascites group ＞ small amount of ascites group ＞ without ascites group (P＜0.05).CHE levels in different groups were Child C group ＜ Child B group ＜ Child A group, the differences in three groups were statistically signi■cant (P＜0.05).CA125 was negative correlated to CHE (r=-0.599, P＜0.05)； and CA125 was positively correlated to the Child-Pugh classi■cation (r=0.736, P＜0.05)； CA125 was positively correlated with the amount of ascites (r=-0.779, P＜0.05).ConclusionThe results show that serum CA125 levels are related to ascites, severity of liver dysfunction and CHE levels.The monitoring of CHE and CA125 levels have certain value in assessing the condition of patients with cirrhosis.

Key words cirrhosis； cancer antigen 125(CA125)； Child-Pugh classi■cation； choline esterase

糖抗原125(cancer antigen 125，CA125)為跨膜黏蛋白16胞外片段，受上皮生長因子受體信號(hào)通路與自身磷酸化調(diào)控，在肝硬化、腹水等患者中有不同程度升高[1]。肝硬化為臨床肝臟病變常見表現(xiàn)，臨床上多采用Child-Pugh分級(jí)作為肝臟手術(shù)評(píng)估依據(jù)，該分級(jí)將膽紅素水平、血清蛋白、凝血酶原時(shí)間作為判斷指標(biāo)。肝硬化合并腹腔積液患者CA125水平升高，CA125受治療因素影響小[2]。血清膽堿酯酶(choline esterase，CHE)主要由肝實(shí)質(zhì)細(xì)胞合成，肝損傷時(shí)血清CHE活性下降[3]。……