重庆地区人群空腹、非空腹血肝功能检测的自身随机对照研究
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摘要
目的评价传统中式饮食对重庆地区人群血生化肝功能检测的影响,探索临床以非清晨空腹血代替清晨空腹血进行肝功能检测的可行性。方法采用前瞻性的自身对照研究方法,分别留取441例受试者空腹及餐后血液标本进行肝功能检测。并将餐前、餐后肝功能差值作为因变量,分析其与性别、年龄、体质量指数(BMI)、既往史、间隔时间、能量物质等因素之间的线性关系,采用SPSS18.0统计软件进行多元线性回归分析。结果受试者空腹及餐后肝功能检测结果显示,男、女性餐前、餐后肝功能差值比较,仅γ-谷氨酰转肽酶(GGT)、清蛋白(ALB)差异有统计学意义(P<0.05)。有既往史组与无既往史组餐前、餐后肝功能差值比较,差异无统计学意义(P>0.05),间隔时间与总胆红素(TBIL)、直接胆红素(DBIL)餐前、餐后差值有线性回归关系,且呈正相关;餐前、餐后球蛋白(GLB)差值与总蛋白(TP)也有线性回归关系,且呈正相关。但肝功能10个指标餐后检测值变化幅度甚微,总体趋势以餐后轻微降低为主,不影响检测结果。结论中式传统早餐餐后非空腹血对重庆地区人群肝功能检测并无影响,清晨非空腹血肝功能检测结果可作为临床诊疗的可靠依据。
Objective To investigate the effect of Chinese traditional breakfast on liver function examination in Chongqing area,and in order to explore whether none-fasting blood sample could be feasible for clinical liver function examination.Methods A prospective self-control study was conducted to examine liver function in 441 subjects with fasting and postprandial blood samples.The difference of liver function between pre-meal and post-meal was taken as dependent variable to analyze its linear relationship with gender,age,body mass index(BMI),past history,interval time and energy substance.The multiple linear regression analysis was carried out with SPSS18.0 statistical software.Results The results of fasting and postprandial liver function test showed that the changes of postgrandial liver function in male and female were only significant difference in gamma-glutamyl transpeptidase(GGT)and albumin(ALB,P<0.05).Between the group with past history and the group without previous history,there was no significant difference in liver function before and after meal(P>0.05).There was a linear regression relationship between interval time and difference value of total bilirubin(TBIL),direct bilirubin(DBIL)before and after meals,and there was a positive correlation.There was a linear regression relationship between total protein(TP)and difference value of globulin(GLB)before and after meals,and there was a positive correlation.However,the changes of 10 indicators of liver function after meals were slight,and the general trend was slightly lower after meals,which did not affect the results.Conclusion Chinese traditional breakfast non-fasting blood has no effect on the detection of liver function in Chongqing population.The results of early morning non-fasting blood liver function test can be used as a reliable basis for clinical diagnosis and treatment.
Objective To investigate the effect of Chinese traditional breakfast on liver function examination in Chongqing area,and in order to explore whether none-fasting blood sample could be feasible for clinical liver function examination.Methods A prospective self-control study was conducted to examine liver function in 441 subjects with fasting and postprandial blood samples.The difference of liver function between pre-meal and post-meal was taken as dependent variable to analyze its linear relationship with gender,age,body mass index(BMI),past history,interval time and energy substance.The multiple linear regression analysis was carried out with SPSS18.0 statistical software.Results The results of fasting and postprandial liver function test showed that the changes of postgrandial liver function in male and female were only significant difference in gamma-glutamyl transpeptidase(GGT)and albumin(ALB,P<0.05).Between the group with past history and the group without previous history,there was no significant difference in liver function before and after meal(P>0.05).There was a linear regression relationship between interval time and difference value of total bilirubin(TBIL),direct bilirubin(DBIL)before and after meals,and there was a positive correlation.There was a linear regression relationship between total protein(TP)and difference value of globulin(GLB)before and after meals,and there was a positive correlation.However,the changes of 10 indicators of liver function after meals were slight,and the general trend was slightly lower after meals,which did not affect the results.Conclusion Chinese traditional breakfast non-fasting blood has no effect on the detection of liver function in Chongqing population.The results of early morning non-fasting blood liver function test can be used as a reliable basis for clinical diagnosis and treatment.
引文
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[12]常克宏,程书权,李新菊,等.采血时间对肝功能检测结果影响的研究[J].实用肝脏病杂志,1999,4(1):47-49.
[13]罗俊生.餐后采血对肝功能8项指标的影响[J].医学理论与实践,2002,15(1):81.
[14]王熙品,蔡建庭,吕文,等.用餐前后肝功能检测对照研究[J].浙江实用医学,1994,3(2):29.
[15]刘淑琴.饮食对肝功能检测结果的影响[J].社区医学杂志,2014,12(18):85-86.
[2]GREEN R M,FLAMM S.AGA technical review on the evaluation of liver chemistry tests[J].Gastroenterology,2002,123(4):1367-1384.
[3]陈煜.肝功能评价指标及预后评估[J].临床肝胆病杂志,2010,26(6):565-567.
[4]ALSTROM T,GRASBECK R,LINDBLAD B,et al.Establishing reference values from adults:recommendation on procedures for the preparation of individuals,collection of blood,and handling and storage of specimens.Committee on Reference Values of the Scandinavian Society for Clinical Chemistry[J].Scand J Clin Lab Invest,1993,53(6):649-652.
[5]王广宇,徐玉萍,陆光辉,等.碳水化合物类饮食对大学生肝、肾功能检测结果的影响[J].华夏医学,2015,5(4):34-37.
[6]程书权,侯淑君.蛋白、脂肪类饮食对肝功能检测结果的影响研究[J].中国全科医学,2001,4(5):360-362.
[7]李兴祥,王兰军.脂肪和蛋白质类饮食对肝功能结果的影响[J].心理医生,2016,22(35):163-164.
[8]LEPPANEN E,DUGUEB.When to collect blood specimens:midmorning vs fasting samples[J].Clin Chem,1998,44(12):2537-2542.
[9]蓝永乐,李介华.采血时间对ALT和AST检测结果的影响[J].国际医药卫生导报,2008,14(22):74-75.
[10]许菊梅.采学时间对ALT和AST检测结果的影响[J].检验医学与临床,2010,7(10):982-983.
[11]张红旭,胡学基,李会芝.早餐前后肝功能变化的临床观察[J].中国误诊学杂志,2002,2(8):1178-1179.
[12]常克宏,程书权,李新菊,等.采血时间对肝功能检测结果影响的研究[J].实用肝脏病杂志,1999,4(1):47-49.
[13]罗俊生.餐后采血对肝功能8项指标的影响[J].医学理论与实践,2002,15(1):81.
[14]王熙品,蔡建庭,吕文,等.用餐前后肝功能检测对照研究[J].浙江实用医学,1994,3(2):29.
[15]刘淑琴.饮食对肝功能检测结果的影响[J].社区医学杂志,2014,12(18):85-86.