关键词: 肝硬化, CA125, Child-Pugh分级, 腹腔积液, 腹膜炎

Abstract: Background　Serum CA125 in patients with cirrhosis shows different degrees of elevation.But the factors associated with it are not complete clear.It is necessary to determine these factors from multiple angles.Objective　To explore the factors associated with the increase of serum CA125 level in patients with cirrhosis.Methods　A total of 205 inpatients with cirrhosis were recruited from the Second Affiliated Hospital of Zhengzhou University from January 2012 to February 2018.According to serum CA125 level，we divided them into normal CA125 group（n=39） and abnormal CA125 group（n=166），and compared total bilirubin，total bile acid，ALT，AST，prothrombin time（PT），albumin，total protein，prothrombin activity，age and sex between the groups.According to the volume of ascites，we divided them into no-ascites group（n=52），mild ascites group（n=40），moderate ascites group （n=51），and severe ascites group（n=62）．In accordance with the Child-Pugh score，we divided them into Child-Pugh grade A group（5-6，n=46），Child-Pugh grade B group（7-9，n=87），and Child-Pugh grade C group（≥10，n=72）．Abdominocentesis was carried out in 113 cases，and by the level of ascitic nucleated cell count，we divided them into normal nucleated cell count group（n=65） and elevated nucleated cell count group（n=48）．Correlations of serum CA125 with the volume of ascites，Child-Pugh grade，and nucleated cell count level were analyzed.Results　Compare with the normal CA125 group，abnormal CA125 group showed higher total bilirubin，total bile acid and AST and longer PT，but lower albumin，total protein，and prothrombin activity（P<0.05）．No-ascites group showed lower serum CA125 level than other 3 ascites groups（P<0.05），so did the mild ascites group when compared with moderate and severe ascites groups（P<0.05）．The serum CA125 level in the elevated nucleated cell count group was higher than that of the normal nucleated cell count group（P=0.023）．Serum CA125 level was lower in Child-Pugh grade A group compared with that of Child-Pugh grade B and C groups（P<0.05）．And it was lower in Child-Pugh grade B group than that of Child-Pugh grade C group（P<0.05）．The volume of ascites，Child-Pugh grade，and ascitic nucleated cell count level were all correlated with serum CA125 level（P<0.05）．Conclusion　Elevated serum CA125 level is associated with the volume of ascites，Child-Pugh grade and ascitic nucleated cell count.So it can be used to assess the volume of ascites，the degree of liver damage and the possibility of peritonitis complications in cirrhosis.

Key words: Liver cirrhosis, CA125, Child-Pugh grade, Ascites volume, Peritoneal inflammation