前白蛋白在评估不同程度酒精性肝病中作用.docVIP

前白蛋白在评估不同程度酒精性肝病中作用 　［摘要］ 目的:前白蛋白在评估酒精性脂肪肝、酒精性肝炎、酒精性肝硬化时的作用，确定其临床病理属性及与其他肝病的鉴别。方法:选出符合中华医学会肝病学分会脂肪肝和酒精性肝病学组制定的酒精性肝病临床诊断标准(讨论稿)的患者65例，测定其血清中的ALT,AST，GGT前白蛋白(PA)。结果:慢性迁延性肝炎、酒精性脂肪肝、酒精性肝炎、酒精性肝硬化的ALT,AST，GGT的结果差异无显著性，酒精性脂肪肝、酒精性肝炎时PA减低不明显，酒精性肝硬化及慢性活动性肝炎时PA降低显著。结论:当长久饮酒史的患者出现ALT,AST，GGT三种酶升高，而难以判定是何种类型升高时，可以做PA检查，PA正常患者可能患有酒精性脂肪肝可戒酒治疗，PA明显降低患者可能患有肝硬化和慢性迁延型肝炎等重症肝病，可进行其他检查以对症治疗。 　　 　　［关键词］ 前白蛋白;酒精性肝病;慢性活动性肝炎　　The Function of Prealbumin in Evaluating Alcoholic Liver Disease(ALD) 　　Abstract:Objective In order to confirm clinical pathologic attribution of ALD，and to identify with other hepatopathy．We studied the function of prealbumin in evaluation of alcoholic fatty liver,alcoholic hepatitis，alcoholic cirrhosis．Methods In accordance with clinical diagnosis criteria of ALD(discussion manuscript)formulated by the Branch of Adiposis Hepatica and Alcoholic Liver Disease Chinese Society of Hepatology Chinese Medical Association，we selected sixtyfive patient．Then we measured prealbumin(PA)in their serum．Results In chronic persistant hepatitis，alcoholic fatty liver，alcoholic hepatitis and alcoholic cirrhosis，the content of ALT,AST and GGT was not significant different．In Alcoholic fatty liver and alcoholic hepatitis，the content of PA was not decreased significantly．However，PA was decreased significantly in alcoholic cirrhosis and chronic active hepatitis．Conclusion We could check PA when the content of ALT,AST and GGT was all increased，but we could not judge which of them was increased in patient drinking for along time．Patient whose PA was normal could suffer from alcoholic fatty liver．They can becured by stoping drinking．Patient whose PA was decreased significantly could suffer from hepatic cirrhosis and chronic persistant hepatitis．In order to cure they shoud be checked other item． 　　Key words：Prealbumin;Alcoholic liver disease;Chronic active hepatitis 　　酒精中毒(alcoholism)系指饮酒所致的精神和躯体障碍,我国酒精中毒的发病率比西方国家为低，但近年来其发病率似有增高趋势，如何界定慢性迁延性肝炎、酒精性脂肪肝、酒精性肝炎、酒精性肝硬化各国的临床诊断标准不同，中华医学会肝病学分会脂肪肝和酒精性肝病学