Ischemia Modified Albumin In Cirrhostic Patients Due To Different Etiology And Its Clinical Value On Liver Function Evaluation

Objective：The value of ischemia modified albumin (IMA) and ischemiamodified albumin albumin ratio (IMAR) in assessing liver function, andwhether IMA and IMAR is a different in cirrhostic patients due todifferent etiology.Methods：Patients with cirrhosis diagnosed according to imaging,biochemistryand/or liver tissue histology hospitaled in China-Japan union Hospital ofJilin University digestive department from February2012to February2014were involved as a group of patients with liver cirrhosis. Healthypeople of physical examination centerduring the same period wereinvolved as the healthy control group. All the people were collectedfasting venous blood for routine biochemical test, including the hepaticfunction, blood coagulation routine, international standardization, ratio(INR), and calculate the Child score. The blood sample after centrifugalplasma were stored in the refrigerator-80℃. By the end of thestudy,determine all the groups of ischemia modified albumin (IMA), andcalculate the IMAR, the latter is mainly to offset the effect to IMA ofalbumin concentrations decreasing, IMAR=ischemia modified albumin(IMA) present albumin. Objective by comparing IMA and IMAR ofcirrhostic patients with different albumin levels, as well as the analysis of IMA and IMAR and liver function correlation between other indicatorsand even Child score, further on the IMA and IMAR and albumin levelstwo diagnostic value of evaluation indexes for evaluation of liver function.In addition between different etiology in patients with cirrhosis throughcomparison between IMA and IMAR, analysis wether the index reflectingthe function of albumin is different in patients with cirrhosis due todifferent etiology.Results：(1) IMA and IMAR in cirrhostic patients with hypoalbuminemiagroup was obviously higher than healthy control, and IMA and IMAR incirrhostic patients with hypoalbuminemia group were significantly higherthan those without hypoalbuminemia group, the above indicate that beforealbumin concentration declines happen in patients with liver cirrhosis,albumin function has decreased;(2) IMA and IMAR have no relation withserum ALT, lactate dehydrogenase and but show significantly related tothe level of bilirubin, INR, that indicate it can reacte reserve,transshipment and synthetic function of the liver;(3) IMA and IMARlevel were positively related to the Child score;(4) IMA and IMAR inalbumin has not significantly decreased when the Child scores can be usedas auxiliary and supplement.(5)Patients with alcoholic liver cirrhosis hashighest IMA and IMAR, followed by cirrhosis of the liver, hepatitis c,hepatitis b cirrhosis of the liver.Conclusion：(1) Before patients with cirrhosis get hypoalbuminemia, the patientsalready have albumin dysfunction, so the IMA and IMAR can earlierdetect abnormal liver albumin synthesis ability;(2) IMA and IMAR showobvious relevanc with bilirubin, INR and CHE, so it can reflect the livertransshipment, synthesis and storage function;(3) IMA and IMAR were positively related to the Child classification, albumin decreased functionof degree to a certain extent, reflects the degree of abnormal liver function.(4)IMA and IMAR can be used as a clinical grading auxiliary even addedChild;(5) The albumin function impairment of patients with alcoholiccirrhosis is most obvious, followed by hepatitis c C liver cirrhosis, thehepatitis B liver cirrhosis.