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

摘要： 背景　肝硬化患者血清CA125呈现不同程度的升高，但肝硬化血清CA125升高的影响因素尚不明确。从多角度分析影响肝硬化患者血清CA125升高的相关因素非常必要。目的　探讨影响肝硬化患者血清CA125水平升高的相关因素。方法　选取2012年1月—2018年2月于郑州大学第二附属医院住院的肝硬化患者205例，行腹腔穿刺113例。分组情况：根据血清CA125水平分为CA125正常组（n=39）与CA125异常组（n=166）；根据腹腔积液量分为无腹腔积液组（n=52）、少量腹腔积液组（n=40）、中量腹腔积液组（n=51）、大量腹腔积液组（n=62）；根据Child-Pugh分级分为Child-Pugh A级组（5~6分）46例、Child-Pugh B级组（7~9分）87例、Child-Pugh C级组（≥10分）72例；根据腹腔积液有核细胞计数分为腹腔积液有核细胞计数正常组65例、腹腔积液有核细胞计数升高组48例（共113例行腹腔穿刺）。比较CA125异常组与CA125正常组的总胆红素、总胆汁酸、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、凝血酶原时间（PT）、清蛋白、总蛋白、凝血酶原活动度、年龄、性别；观察腹腔积液量与血清CA125水平的相关性、Child-Pugh分级与血清CA125水平的相关性、腹腔积液有核细胞计数与血清CA125水平的相关性。结果　CA125异常组总胆红素、总胆汁酸、AST高于CA125正常组，PT长于CA125正常组，清蛋白、总蛋白、凝血酶原活动度低于CA125正常组（P<0.05）。无腹腔积液组血清CA125水平低于少量腹腔积液组、中量腹腔积液组、大量腹腔积液组（P<0.05）；少量腹腔积液组血清CA125水平低于中量腹腔积液组、大量腹腔积液组（P<0.05）。Child-Pugh A级组血清CA125水平低于Child-Pugh B级组、Child-Pugh C级组（P<0.05）；Child-Pugh B级组血清CA125水平低于Child-Pugh C级组（P<0.05）。腹腔积液有核细胞计数升高组血清CA125水平高于腹腔积液有核细胞计数正常组（P=0.023）。腹腔积液量、Child-Pugh分级、腹腔积液有核细胞计数与血清CA125水平均相关（P<0.05）。结论　血清CA125水平升高与腹腔积液量、Child-Pugh分级及腹腔积液有核细胞计数相关，其可用来评估腹腔积液量的多少、肝功能受损程度及出现腹膜炎并发症的可能性。

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