四种类型酒精性肝病对肝脏相关血液指标的影响
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摘要
探讨四种类型酒精性肝病(ALD)对肝脏相关血液指标的影响。收集住院酒精性肝病137例患者,分为轻症酒精性肝病(MALD) 31例,酒精性脂肪肝(AFL) 26例,酒精性肝炎(AH) 27例,酒精性肝硬化(AC) 53例,并选择同期住院的非酒精性肝病患者37例为对照组,分析相关血液指标与酒精性肝病分型之间的关系。所有四种类型酒精性肝病患者的血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(AKP)、γ-谷氨酰转肽酶(γ-GT)均高于对照组;酒精性肝硬化组年龄、谷草转氨酶/谷丙转氨酶(AST/ALT)、凝血酶原时间(PT)、国际标准化比值(INR)大于其他三组和对照组,但血清总蛋白质(TP)、清蛋白(ALB)、白球比(A/G)、总胆固醇(TC)、甘油三酯(TG)、凝血酶原活动度(PTA)、红细胞(RBC)、血红蛋白(HGB)、血细胞压积(HCT)低于其他三组和对照组(P<0. 05)。所有酒精性肝病均可造成肝脏酶谱的升高。当病情发展至肝硬化期时,可引起血清蛋白质、血脂及血细胞及凝血指标的改变。
To investigate the effects of four types of alcoholic liver diseases on hepatic associated blood indicators.137 cases of inpatients with alcoholic liver diseases were collected,including 31 cases of inpatients with mild alcoholic liver disease,26 cases of inpatients with alcoholic fatty liver,27 cases of inpatients with alcoholic hepatitis,53 cases of inpatients with alcoholic cirrhosis,and 37 cases of inpatients with non-alcoholic liver disease in the same period were selected as the control group.This study aimed to analyze the relationship between the relevant blood indicators and the above four types of alcoholic liver diseases. The serum of alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,γ-Glutamine transpeptidase of patients with four types of alcoholic liver diseases were higher than the control group,the age,Ratio of aspartate aminotransferase to alanine aminotransferase,prothrombin time and International Standardized Ratio of patients in the group of alcoholic cirrhosis were higher than the other three groups of ALD and the control group,but total protein,albumin,Ratio of albumin to globulin,total cholesterol,triglyceride,prothrombin time,Red blood cell,hemoglobin,Hematocrit in the group of alcoholic cirrhosis were lower than the other three groups of ALD and the control group,the differences were statistically significant( P<0.05). All kinds of alcoholic liver diseases could result in elevated hepatic enzymogram. When the disease developed into liver cirrhosis,it may cause changes of serum proteins,blood lipids,blood cells and coagulation indicator.
To investigate the effects of four types of alcoholic liver diseases on hepatic associated blood indicators.137 cases of inpatients with alcoholic liver diseases were collected,including 31 cases of inpatients with mild alcoholic liver disease,26 cases of inpatients with alcoholic fatty liver,27 cases of inpatients with alcoholic hepatitis,53 cases of inpatients with alcoholic cirrhosis,and 37 cases of inpatients with non-alcoholic liver disease in the same period were selected as the control group.This study aimed to analyze the relationship between the relevant blood indicators and the above four types of alcoholic liver diseases. The serum of alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,γ-Glutamine transpeptidase of patients with four types of alcoholic liver diseases were higher than the control group,the age,Ratio of aspartate aminotransferase to alanine aminotransferase,prothrombin time and International Standardized Ratio of patients in the group of alcoholic cirrhosis were higher than the other three groups of ALD and the control group,but total protein,albumin,Ratio of albumin to globulin,total cholesterol,triglyceride,prothrombin time,Red blood cell,hemoglobin,Hematocrit in the group of alcoholic cirrhosis were lower than the other three groups of ALD and the control group,the differences were statistically significant( P<0.05). All kinds of alcoholic liver diseases could result in elevated hepatic enzymogram. When the disease developed into liver cirrhosis,it may cause changes of serum proteins,blood lipids,blood cells and coagulation indicator.
引文
[1]中华医学会肝病学分会脂肪肝和酒精性肝病学会,中国医师协会脂肪性肝病专家委员会.酒精性肝病防治指南(2018年更新版)[J].临床肝胆病杂志,2018,34(5):939-46.
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[5]唐吉斌,黄毓玲,张盛,等.CDT、CDT/TRF比值在酒精性肝病中的诊断价值[J].实验与检验医学,2018,36(2):214-5,233.
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[10]ARANTZA LAMAS-PAZ,FENGJIE HAO,LEONARD J NEL-SON,et al.Alcoholic liver disease:utility of animal models[J].World J Gastroenterol,2018,24(45):5063-75.
[11]袁乐媛,韩惠芳,高君,等.酒精性肝病与血脂代谢相关性分析[J].胃肠病学和肝病学杂志,2015,24(8):973-6.
[12]GRASSELLI E,COMPALATI AD,VOCI A,et al.Altered oxidative stress/antioxidant status in blood of alcoholicsubjects is associated with alcoholic liver disease[J].Drug Alcohol Depend,2014,143:112-9
[13]唐金凤.慢性及晚期血吸虫病、慢性乙型肝炎和乙肝肝硬化患者凝血、肝功能及血细胞分析的实验诊断研究[D].南昌:南昌大学,2016:29.
[14]候静,路越,张德凯.肠道菌群失调与肝脏疾病的关系[J].临床肝胆病杂志,2018,34(5):1128-32.
[2]崔雷,洪阳,周力,等.贵阳市成年体检人群酒精性肝病的流行病学调查[J].贵州医药,2010,34(7):645-7.
[3]白玛康卓,欧珠罗布,次仁央宗,等.西藏拉萨地区世居成年藏族居民酒精性肝病患病现状及其影响因素[J].中国公共卫生,2016,32(3):295-8.
[4]李倩楠,常剑波,白艳霞,等.延长油田职工酒精性肝病的流行病学调查[J].临床肝胆病杂志,2017,33(9):1769-73.
[5]唐吉斌,黄毓玲,张盛,等.CDT、CDT/TRF比值在酒精性肝病中的诊断价值[J].实验与检验医学,2018,36(2):214-5,233.
[6]林秀贤,陈丹,赵青,等.影响酒精性肝病发病的遗传学研究进展[J].中国临床药理学与治疗学,2017,22(11):1309-14.
[7]窦慧馨,张得钧.酒精性肝病分子发病机制研究进展[J].基因组学与应用生物学,2016,35(7):1643-7.
[8]TORKADI PP,APTE IC,BHUTE AK.Biochemical evaluation of patients of alcoholic liver disease and non-alcoholic liver disease[J].Ind J Clin Biochem,2014,29(1):79-83.
[9]SEITZ HK,MUELLER S.The role of Cytochrom P4502E1 in Alcoholic Liver Disease and alcohol mediated carcinogenesis[J].ZGastroenterol,2019,57:37-45.
[10]ARANTZA LAMAS-PAZ,FENGJIE HAO,LEONARD J NEL-SON,et al.Alcoholic liver disease:utility of animal models[J].World J Gastroenterol,2018,24(45):5063-75.
[11]袁乐媛,韩惠芳,高君,等.酒精性肝病与血脂代谢相关性分析[J].胃肠病学和肝病学杂志,2015,24(8):973-6.
[12]GRASSELLI E,COMPALATI AD,VOCI A,et al.Altered oxidative stress/antioxidant status in blood of alcoholicsubjects is associated with alcoholic liver disease[J].Drug Alcohol Depend,2014,143:112-9
[13]唐金凤.慢性及晚期血吸虫病、慢性乙型肝炎和乙肝肝硬化患者凝血、肝功能及血细胞分析的实验诊断研究[D].南昌:南昌大学,2016:29.
[14]候静,路越,张德凯.肠道菌群失调与肝脏疾病的关系[J].临床肝胆病杂志,2018,34(5):1128-32.