【摘要】目的 探討血清γ-球蛋白在評(píng)估肝臟儲(chǔ)備功能中的作用。方法 對(duì)30例肝臟腫瘤切除術(shù)的患者術(shù)前進(jìn)行肝功能分級(jí)以及血清蛋白電泳檢查,分析γ-球蛋白與手術(shù)前、后肝功能Child-Pugh分級(jí)的關(guān)系,以及用血清γ-球蛋白作為評(píng)估標(biāo)準(zhǔn)與肝功能Child-Pugh分級(jí)的符合程度。結(jié)果 術(shù)前肝功能Child-Pugh分級(jí)A級(jí)的26例患者血清γ-球蛋白為(21.053 3±6.001 4)%,明顯低于4例B級(jí)患者的(28.800 0±8.672 5)%,差異有統(tǒng)計(jì)學(xué)意義(P<0.05); 術(shù)后肝功能Child-Pugh分級(jí)A級(jí)的25例患者術(shù)前血清γ-球蛋白為(21.022 0±5.354 6)%,明顯低于5例B、C級(jí)患者的(29.556 0±7.698 5)%,差異同樣有統(tǒng)計(jì)學(xué)意義(P<0.05); 以血清γ-球蛋白 gt;30%作為預(yù)測術(shù)后肝功能代償不良的標(biāo)準(zhǔn),其敏感性(80.00%)、特異性(96.00%)都較好。結(jié)論 術(shù)前患者血清γ-球蛋白可以反映其肝臟儲(chǔ)備功能,結(jié)合患者術(shù)前血清γ-球蛋白監(jiān)測結(jié)果和肝功能Child-Pugh分級(jí)能夠更客觀地評(píng)估肝臟占位病變患者肝臟儲(chǔ)備功能情況。
引用本文: 梁鵬 ,尹杰,王璇,曾勇. 血清γ-球蛋白評(píng)價(jià)肝臟儲(chǔ)備功能的臨床研究. 中國普外基礎(chǔ)與臨床雜志, 2008, 15(4): 274-277. doi: 復(fù)制
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- 2. 朱化剛. 術(shù)前肝臟儲(chǔ)備功能的判斷與安全肝切除量 [J]. 肝膽外科雜志, 2005; 13(6)∶406.
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- 5. Poon RT, Fan ST. Assessment of hepatic reserve for indication of hepatic resection: how I do it [J]. J Hepatobiliary Pancreat Surg, 2005; 12(1)∶31.
- 6. 嚴(yán)律南, 陳曉理, 李志輝, 等. 肝癌肝切除術(shù)圍手術(shù)期處理的臨床研究(附2 143 例報(bào)告) [J]. 中國普外基礎(chǔ)與臨床雜志, 2005; 12(2)∶162.
- 7. Li GH, Zhu SL, Li JQ, et al. Evaluation of partial hepatectomy for primary liver carcinoma [J]. J Surg Oncol, 1989; 41(1)∶5.
- 8. Wakabayashi H, Ishimura K, Izuishi K, et al. Evaluation of liver function for hepatic resection for hepatocellular carcinoma in the liver with damaged parenchyma [J]. J Surg Res, 2004; 116(2)∶248.
- 9. 李琴, 王寶恩, 賈繼東, 等. 肝功能分級(jí)的演變及特點(diǎn): 從Child到MELD [J]. 中華肝臟病雜志, 2004; 12(5)∶319.
- 10. 雷團(tuán)結(jié), 黎一鳴, 陳域, 等. D-山梨醇肝清除率評(píng)估肝儲(chǔ)備功能的臨床研究 [J]. 中國實(shí)用外科雜志, 2005; 25(2)∶103.
- 11. 彭寶崗, 黃潔夫, 呂明德, 等. 肝功能試驗(yàn)綜合預(yù)測肝癌病人的肝儲(chǔ)備功能 [J]. 中山醫(yī)科大學(xué)學(xué)報(bào), 1995; 16(2)∶44.
- 12. 呂明德, 黃潔夫, 彭寶崗, 等. 多因素分析兩步判別法預(yù)測肝功能儲(chǔ)備力 [J]. 中華外科雜志, 1994; 32(12)∶745.
- 13. Maruyama S, Hirayama C, Horie Y, et al. Serum immunoglobulins in patients with chronic hepatitis C: a surrogate marker of disease severity and treatment outcome [J]. Hepatogastroenterology, 2007; 54(74)∶493.
- 14. Fernandez FJ, Rivas G, Salgado J, et al. Comparative evaluation of serum protein analysis by capillary zone electrophoresis and agarose gel electrophoresis [J]. Am Clin Lab, 2002; 21(4)∶26.
- 15. 王庸晉. 現(xiàn)代臨床檢驗(yàn)學(xué) [M]. 第2版. 北京: 人民軍醫(yī)出版社, 2000∶272.
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