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目的:探讨肝硬化肝性脑病患者血清S100B检测的临床价值。方法:收集35例正常健康体检志愿者(对照组),105例就诊我院的肝硬化患者(病例组),对所有入选者均进行血清S100B检测,另病例组均进行血氨、肝功能、电解质以及凝血功能测定,检测血清S100B采用酶联免疫法,并对观察值进行统计学处理。结果:1.肝硬化合并肝性脑病组血清S100B含量较肝硬化非肝性脑病及正常对照组明显增高,具有极显著差异(P<0.01);29例入院时已经确诊为肝性脑病的患者,经谷氨酸钠、精氨酸、甘露醇或保留灌肠等治疗后,肝性脑病病情控制,第7天复查血清S100B,较治疗前明显减低,且治疗前后比较有显著差异(P<0.05);观察15例肝性脑病合并低钠血症组血清S100B值,并与单纯肝性脑病及单纯低钠血症比较,混合组血清S100B值明显高于另外两组,有显著差异(P<0.05)。2.所有肝硬化并发肝性脑病患者经ch ild-pugh分级并与患者血清S100B值进行相关分析,发现两者高度正相关(相关系数为r=0.898)。3.对所有肝硬化患者根据血清S100B值进行分组,S100B高值组患者肝性脑病的发病率高于低值组(P<0.05);对入院时肝硬化非肝性脑病患者根据血清S100B值进行分组,S100B高值组入院后进展为肝性脑病发生率高于低值组(P<0.05)。结论:血清S100B的测定有助于肝性脑病的诊断和脑实质损害情况的判断,在临床上对病情的估计、预后的判断和及时采取有效治疗措施有一定的帮助作用。
Objective: To investigate the clinical value of serum S100B detection in cirrhotic patients with hepatic encephalopathy. Methods: 35 normal healthy volunteers (control group) and 105 cirrhotic patients (case group) were enrolled in this study. Serum S100B was detected in all the patients, and serum ammonia, liver function, Electrolytes and coagulation assay, serum S100B detected by enzyme-linked immunosorbent assay, and the observations were statistically processed. Serum levels of S100B in patients with cirrhosis and hepatic encephalopathy were significantly higher than those in patients with cirrhosis and non-hepatic encephalopathy (P <0.01); 29 patients with already diagnosed hepatic encephalopathy , After treatment with sodium glutamate, arginine, mannitol or retention enema, the condition of hepatic encephalopathy was controlled. On the 7th day, the serum S100B level was significantly lower than before treatment, and there was significant difference before and after treatment (P <0.05 ). The S100B value of 15 patients with hepatic encephalopathy complicated with hyponatremia was observed. Compared with simple hepatic encephalopathy and simple hyponatremia, the serum S100B value in the mixed group was significantly higher than the other two groups (P < 0.05). 2. All patients with cirrhosis complicated with hepatic encephalopathy were classified by child-pugh and correlated with serum S100B values. There was a positive correlation between the two (r = 0.898). The incidence of hepatic encephalopathy in patients with S100B high value group was higher than that in the low value group (P <0.05) .All patients with cirrhosis non-hepatic encephalopathy were classified according to serum S100B value After the admission, the incidence of hepatic encephalopathy in S100B high-value group was higher than that in low-value group (P <0.05). Conclusion: The determination of serum S100B is helpful for the diagnosis of hepatic encephalopathy and judgment of the damage of brain parenchyma. It is helpful to estimate the condition, judge the prognosis and take timely and effective treatment in clinic.