CAJ | 학술논문

目的探讨甲胎蛋白(AFP)含量及其动态变化与慢加急性肝功能衰竭预后的关系.方法对78例慢加急性肝功能衰竭患者进行回顾性分析,依据病情将患者分为早、中、晚三期,患者均给予内科常规治疗,根据治疗结果将各期患者分为存活组与死亡组.分析两组患者AFT、总胆红素(TBiL)、凝血酶原活动度(PTA)的峰值及其动态变化对患者预后的影响.结果慢加急性肝功能衰竭早期和中期患者存活组AFP和VIA的峰值明显高于死亡组(P＜0.05),TBiL的峰值存活组显著低于死亡组(P＜0.05),而晚期患者的AFP、TBiL和PTA的峰值存活组和死亡组间无统计学意义.AFP上升和/或TBiL下降对早、中、晚期患者预后的敏感性均为100%,特异性分别为86%、71%和50%.结论慢加急性肝功能衰竭患者血清AFP含量升高反映肝细胞再生活跃,提示预后良好.
목적 탐토갑태단백(AFP)함량급기동태변화여만가급성간공능쇠갈예후적관계.방법 대78례만가급성간공능쇠갈환자진행회고성분석,의거병정장환자분위조、중、만삼기,환자균급여내과상규치료,근거치료결과장각기환자분위존활조여사망조.분석량조환자AFT、총담홍소(TBiL)、응혈매원활동도(PTA)적봉치급기동태변화대환자예후적영향.결과 만가급성간공능쇠갈조기화중기환자존활조AFP화VIA적봉치명현고우사망조(P＜0.05),TBiL적봉치존활조현저저우사망조(P＜0.05),이만기환자적AFP、TBiL화PTA적봉치존활조화사망조간무통계학의의.AFP상승화/혹TBiL하강대조、중、만기환자예후적민감성균위100%,특이성분별위86%、71%화50%.결론 만가급성간공능쇠갈환자혈청AFP함량승고반영간세포재생활약,제시예후량호.
Objective To investigate the relationship between the alpha-fetoprotein(AFP) value changes and prognosis in acute on chronic liver failure.Methods 78 cases of acute on chronic liver failure patients were retrospectively analyzed.All the patients were divide into three stages: ealy stage,medium-term stage,advanced stage.In every stage,according to the final results the patients were divided into survival group and death group.Maximum values of the AFP,TBiL and PTA were analyzed in the two groups,and their value changes were used to prognose of acute on chronic liver failure.Results In ealy stage and medium-term stage the maximum values of the AFP and PTA were significantly higher in survival group than that in death group,and the maximum values of TBil was significantly lower in survival group than that in death group.However,in advanced stage the maximum values of the AFP,TBiL and PTA have no significant difference.The increasing AFP and/or decreasing TBiL levels predict well outcome of acute on chronic liver failure,which sensitivity were 100% in all stages and specificity were respectively 86%,71%,50% in the ealy stage,medium-term stage and advanced stage.Conclusion Our observations suggest that rising level of AFP and decreasing level of TBiL frequently indicated survival.