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目的观察肝病患者血清肉碱水平,探讨其临床意义,为肉碱治疗肝病提供依据。方法用酶循环法检测25例急性病毒性肝炎,34例慢性病毒性肝炎,22例肾功能正常及9例肾功能异常的肝炎后肝硬化患者血清游离肉碱水平,并分别与40名正常人的检测值比较。结果血清游离肉碱:正常人为(48．3±10．2)μmol／L;急性病毒性肝炎患者为(35．2±13．2)μmol／L,明显低于正常对照组,P=0．000。慢性病毒性肝炎患者为(36．5±9．9) μmol／L,明显低于正常对照组,P=0．000。肾功能正常的肝炎后肝硬化患者为(45．0±11．0)μmol／L,比正常对照组略有下降,但差异无统计学意义,P=0．232。肾功能异常的肝炎后肝硬化患者为(83．6±50.4)μmol／L,比正常对照组升高,但差异无统计学意义,P=0．069。结论肝病患者可发生肉碱代谢异常,肝脏疾病是导致继发性肉碱缺乏的原因之一。
Objective To observe the serum carnitine level in patients with liver disease and to explore its clinical significance and provide basis for carnitine treatment of liver disease. Methods Serum free carnitine levels in 25 patients with acute viral hepatitis, 34 patients with chronic viral hepatitis, 22 patients with normal renal function and 9 patients with renal dysfunction were detected by enzyme-linked immunosorbent assay Comparison of test values. Results Serum free carnitine was (48.3 ± 10.2) μmol / L in normal controls and (35.2 ± 13.2) μmol / L in patients with acute viral hepatitis, which was significantly lower than that in normal controls (P = 0 .000. Chronic viral hepatitis patients (36.5 ± 9.9) μmol / L, significantly lower than the normal control group, P = 0.000. The patients with normal renal function and liver cirrhosis were (45.0 ± 11.0) μmol / L, which were slightly lower than those in normal control group, but the difference was not statistically significant (P = 0.232). Patients with posthepatitic cirrhosis with renal dysfunction were (83.6 ± 50.4) μmol / L higher than those in the normal control group, but the difference was not statistically significant (P = 0.069). Conclusions Patients with liver disease may have abnormal carnitine metabolism, and liver disease is one of the reasons leading to secondary carnitine deficiency.