解放军医学院学报
解放軍醫學院學報
해방군의학원학보
Academic Journal of Chinese Pla Medical School
2013年
2期
130-132
,共3页
王晗%徐军%刘佳%郭静霞%谢娜%赵静%陈霖%宋永继%杨丽华%刘爱霞%李伯安%毛远丽
王晗%徐軍%劉佳%郭靜霞%謝娜%趙靜%陳霖%宋永繼%楊麗華%劉愛霞%李伯安%毛遠麗
왕함%서군%류가%곽정하%사나%조정%진림%송영계%양려화%류애하%리백안%모원려
primary biliary cirrhosis%biuret colorimetry%enzymic colorimetry%protein
目的分析抗线粒体M2亚型抗体阳性(AMA-M2)的原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)患者生物化学指标特点,为临床PBC诊治提供帮助.方法对本院2010年8月-2012年3月280例AMA-M2阳性的PBC患者分别检测血清蛋白、脂类、胆红素及酶类等16项血清生物化学指标.采用毛细电泳技术,分析患者6种血清蛋白变化情况.采用光电比色法和发色(吸光度)法分别检测患者WBC、RBC、HGB、PLT以及PT等临床血液学指标.采用魏氏法检测患者血沉变化.结果生化指标检测结果显示,血清蛋白及脂类以ALB、TC异常率最高,分别为52%、40%.超过50%的患者出现酶类及胆红素代谢结果异常,异常率由高到低分别为GGT(96%)、ALP(93%)、TBA(81%)、AST(73%)、DB(66%)、CHE(66%)、LAP(63%)、ALT(61%)、TB(54%),其中以DB、GGT、TBA变化幅度最高[≥2倍正常值上限(ULN)],其次为ALP、TB、ALT、AST(1倍ULN),LAP低于1倍ULN.患者血清蛋白电泳结果异常主要体现在γ球蛋白和白蛋白百分比,异常率分别为71%和57%,且前者出现低于1倍ULN升高.近半数患者出现临床血液学指标变化,异常率由高到低是:ESR、HGB、RBC、PT、PLT、WBC,其中以ESR的异常率最为突出84%,其余依次为HGB(49%)、RBC(46%)、PT(44%)、PLT(41%)、WBC(39%),变化幅度以ESR最高(1倍ULN),其次为RBC、HGB、PT(≤1倍ULN).结论 PBC患者血清蛋白和脂类、酶类和胆红素代谢以及血清蛋白分布等多种生化指标变化特点,结合临床血液学特点,将为PBC的临床诊断提供重要帮助.关键词:原发性胆汁性肝硬化;双缩脲比色法;酶比色法;蛋白
目的分析抗線粒體M2亞型抗體暘性(AMA-M2)的原髮性膽汁性肝硬化(primary biliary cirrhosis,PBC)患者生物化學指標特點,為臨床PBC診治提供幫助.方法對本院2010年8月-2012年3月280例AMA-M2暘性的PBC患者分彆檢測血清蛋白、脂類、膽紅素及酶類等16項血清生物化學指標.採用毛細電泳技術,分析患者6種血清蛋白變化情況.採用光電比色法和髮色(吸光度)法分彆檢測患者WBC、RBC、HGB、PLT以及PT等臨床血液學指標.採用魏氏法檢測患者血沉變化.結果生化指標檢測結果顯示,血清蛋白及脂類以ALB、TC異常率最高,分彆為52%、40%.超過50%的患者齣現酶類及膽紅素代謝結果異常,異常率由高到低分彆為GGT(96%)、ALP(93%)、TBA(81%)、AST(73%)、DB(66%)、CHE(66%)、LAP(63%)、ALT(61%)、TB(54%),其中以DB、GGT、TBA變化幅度最高[≥2倍正常值上限(ULN)],其次為ALP、TB、ALT、AST(1倍ULN),LAP低于1倍ULN.患者血清蛋白電泳結果異常主要體現在γ毬蛋白和白蛋白百分比,異常率分彆為71%和57%,且前者齣現低于1倍ULN升高.近半數患者齣現臨床血液學指標變化,異常率由高到低是:ESR、HGB、RBC、PT、PLT、WBC,其中以ESR的異常率最為突齣84%,其餘依次為HGB(49%)、RBC(46%)、PT(44%)、PLT(41%)、WBC(39%),變化幅度以ESR最高(1倍ULN),其次為RBC、HGB、PT(≤1倍ULN).結論 PBC患者血清蛋白和脂類、酶類和膽紅素代謝以及血清蛋白分佈等多種生化指標變化特點,結閤臨床血液學特點,將為PBC的臨床診斷提供重要幫助.關鍵詞:原髮性膽汁性肝硬化;雙縮脲比色法;酶比色法;蛋白
목적분석항선립체M2아형항체양성(AMA-M2)적원발성담즙성간경화(primary biliary cirrhosis,PBC)환자생물화학지표특점,위림상PBC진치제공방조.방법대본원2010년8월-2012년3월280례AMA-M2양성적PBC환자분별검측혈청단백、지류、담홍소급매류등16항혈청생물화학지표.채용모세전영기술,분석환자6충혈청단백변화정황.채용광전비색법화발색(흡광도)법분별검측환자WBC、RBC、HGB、PLT이급PT등림상혈액학지표.채용위씨법검측환자혈침변화.결과생화지표검측결과현시,혈청단백급지류이ALB、TC이상솔최고,분별위52%、40%.초과50%적환자출현매류급담홍소대사결과이상,이상솔유고도저분별위GGT(96%)、ALP(93%)、TBA(81%)、AST(73%)、DB(66%)、CHE(66%)、LAP(63%)、ALT(61%)、TB(54%),기중이DB、GGT、TBA변화폭도최고[≥2배정상치상한(ULN)],기차위ALP、TB、ALT、AST(1배ULN),LAP저우1배ULN.환자혈청단백전영결과이상주요체현재γ구단백화백단백백분비,이상솔분별위71%화57%,차전자출현저우1배ULN승고.근반수환자출현림상혈액학지표변화,이상솔유고도저시:ESR、HGB、RBC、PT、PLT、WBC,기중이ESR적이상솔최위돌출84%,기여의차위HGB(49%)、RBC(46%)、PT(44%)、PLT(41%)、WBC(39%),변화폭도이ESR최고(1배ULN),기차위RBC、HGB、PT(≤1배ULN).결론 PBC환자혈청단백화지류、매류화담홍소대사이급혈청단백분포등다충생화지표변화특점,결합림상혈액학특점,장위PBC적림상진단제공중요방조.관건사:원발성담즙성간경화;쌍축뇨비색법;매비색법;단백
Objective To provide the reference for the diagnoisis and treatment of primary biliary cirrhosis (PBC) by studying the biochemical characteristics of PBC patients with positive anti-mitochondrial antibody M2 subtype (AMA-M2). Methods Two hundred and eighty PBC patients with positive AMA-M2 admitted to our hospital from August 2010 to March 2012 were included in this study. Their 16 serum biochemical indexes such as serum protein, lipid, bilirubin and enzymes were tested. Six kinds of serum proteins were analyzed by capillary electrophoresis. WBC, RBC, HGB, PLT and PT were calculated by photoelectric colorimetry and chromophoremetry (absorbency), respectively. Sedimentation was measured by Western method. Results Biochemical analysis showed that the percentage of abnormal serum protein and lipid (ALB, TC) was 52%and 40%, respectively. The metabolism of enzymes and bilirubin was abnormal in more than 50%of the patients. The percentage of abnormal GGT, ALP, TBA, AST, DB, CHE, LAP, ALT, and TB was 96%, 93%, 81%, 73%, 66%, 66%, 63%, 61%, 54%, respectively. The DB, GGT, and TBA were 2-fold higher than the ULN. The ALP, TB, ALT, and AST were 1-fold higher than the ULN. The LAP was 1-fold lower than the ULN. Capillary electrophoresis showed that the percentage of abnormalγ-globulin and albumin was 71%and 57%, respectively, and was l-fold lower than the ULN. The abnormal clinical hematology indicators were found in more than 50%of the patients. Tthe percentage of abnormal ESR, HGB, RBC, PT, PLT, and WBC was 84%, 49%, 46%, 44%, 41%, and 39%, respectively. The percentage of abnormal sedimentation was 84%(1-fold higher than the ULN). The percentage of abnormal RBC, HGB, and PT was≤1-fold of the UNL. Conclusion Features of a variaty of biochemical indexes such as serum protein, lipid, metabolism of bilirubin and enzyme, distribution of serum protein molecules in combination of clinical hematological test contribute greatly to the clinical diagnosis of PBC.
