The Difference And Clinical Significance Of Ischemia-modified Albumin(IMA) Between Chronic Liver Disease And Chronic Renal Disease

Object: Through contrasting whether the differences in ischemia-modifiedalbumin or the ratios of ischemia-modified albumin and albumin betweennephropathy hypoproteinemia and cirrhosis hypoproteinemia, clarify whetherthese tips for albumin refers to a specific function in patients with cirrhosis.Through the research and demonstration of cirrhotic patients,assess their valuein terms of severity and prognosis of cirrhosis.Methods:The patients with cirrhosis hospitalized in Gastroenterology and thepatients with chronic renal disease hospitalized in Nephrology from February2013to February2014in China-Japan union Hospital of JilinUniversity,exclusion of patients with severe cardiovascular disease, blood andendocrine system diseases which the disease has not been controlledby,malnourished patients with primary liver cancer or other malignancies, thepatients with ischemic disease, oxidative stress and ketoacidosis and acutekidney injury. Collect general data of all patients, and determine ALT, AST,ALB, TBIL, DBIL, prothrombin INR value, BUN, CREA, RBP, urinary proteinlevels, IMA levels. The patients were divided into hypoalbuminemia groupsand non-hypoproteinemia groups. Compare the differences of IMA and IMARbetween two groups of patients. Then the two groups were divided intocirrhosis with kidney injury group, simple liver cirrhosis group and simplerenal injury group.Compare the differences of IMA and IMAR between thethree groups. Explore the relationship between IMA,IMAR and relatedindicators of liver inflammation,indicators of liver synthesis, metabolism,transport function in patients with cirrhosis. Explore the relationship betweencorrelation, cause of cirrhosis and IMA, IMAR level, between IMA, IMARlevel and Child-Pugh score. Analyze the relationship between IMA, IMARvalue and BUN, CREA, RBP, urinary protein levels,creatinine clearance rates.In patients with chronic kidney disease. Results:(1)Hypoproteinemia patients ischemia modified albumin (IMA) andthe proportion of ischemia-modified albumin (IMAR) were significantly higherthan of patients without hypoproteinemia.(2) In hypoproteinemia group，ischemia modified albumin levels and propotion of ischemia-modified albuminin patients with hepatic cirrhosis and renal injuruy were significantly higherthan simple renal disease group, and no significant statistically significant.compared with simple hepatic cirrosisi group.(3) There is no statisticalsignificance among of three subgroups of non-Hypoproteinemia inischemia-modified albumin level and ischemia-modified albumin/albuminlevel.(4)In patients with hepatic cirrosis, the ischemia modified albumin levelsand the propotion of ischemia-modified albumin is not interrelated withTransaminase levels and index of renal function,and is significantly interrelatedwith the serum bilirubin levels and INR..(5) In patients with hepatic cirrosis,ischemia modified albumin levels and propotion of ischemia-modified albuminis significant interrelated with their Child-Pugh score.(6)The ischemiamodified albumin levels and the propotion of ischemia-modified albuminamong hepatic cirrhosis of different causes are both alcoholic cirrhosis,Cirrhosis of Hepatitis C, cirrhosis of other causes, Cirrhosis of Hepatitis C.Conclusion:Not only albumin in patients in hypoproteinemia drop, albuminfunction was significantly reduced.In patients with non-hypoalbuminemiagroup,there is no significant changes in the function of albumin; Albuminfunction in cirrhotic patients is interrelated with with cirrhosis severity,：thehigher the Child-Pugh score, the worse the albumin function;. Albuminfunction in patients with cirrhosis is not interrelated with the index that reflectliver inflammation and renal function,but is significantly interrelated with theindex that reflect liver function of synthesis, metabolism, transport:the higherthese index,the worse the albumin function. The ischemia modified albuminlevels and the propotion of ischemia-modified albumin among hepatic cirrhosis of different causes are both alcoholic cirrhosis, Cirrhosis of Hepatitis C,cirrhosis of other causes, Cirrhosis of Hepatitis C.