Value Of Serum Cholinesterase Activity (CHE) To Evaluate Liver Reserve Function In Cirrhotic Patients In Operation

Objective: to observe the value of serum cholinesterase activity (CHE) to evaluate liver reserve function in cirrhotic patients in operation.Methods: retrospective analysis of 248 cirrhotic patients and 113 cirrhotic patients undergoing pericardial devascularization in our hospital from 1996 to 2003. Results: serum CHE changed same as serum albumin , with serum albumin decreasing , serum CHE decreased too . With the liver function descending , the serum CHE decreased too . Child C group and Child B group,Child B group and Child A group reached statistical significance ( P< 0.05) . Serum CHE reached statistical significance ( P <0.05),which preoperative hepatic function grade was Child A , postoperative hepatic function grade was Child A ,Child B ,Child C . And serum CHE reached statistical significance ( P <0.05) , which preoperative hepatic function grade was Child B , postoperative hepatic function grade was Child B ,Child C . Whatever preoperative hepatic function grade was Child A ,Child B or Child C , if postoperative hepatic function grade was Child C , serum CHE didn't reach statistical significance ( P <0.05).Hepatic function grade of the patients who had complication of ascites,jaundice or hepatic encephalopathy was 27 patients of Child A,24 patients of Child B,17 patients of Child C .Hepatic function grade of the patients who hadn't any complication was 24 patients of Child A,14 patients of Child B,3 patients of Child C. Serum CHE of the two groups reached statistical significance ( P <0.05) . There were 5 patients who had hepatic encephalopathy postoperation in the 113 patients undergoing pericatdial devascularization ,1 patient was died , and preoperative serum CHE were all lower then 1900u/l . Though another 5 patients had not hepatic encephalopathy, they all had ascites ,and 2 of them had a mass of ascites and had jaundice, and preoperative serum CHE was 1585u/l,1887u/l . Conclusion : Serum CHE changes with the severity of cirrhotic liver. Because it is little effected by other factor without liver and half-life is short and method of check is simple ,it can be one of the methods to evaluate the reserve function of cirrhotic liver . Using serum CHE to evaluate hepatic reserve function can make up of Child grade .If the preoperative serum CHE is lower then 1900u/l , liver failure maybe happen . ...