巨细胞病毒肝炎患儿血清肝纤维化指标检测的意义

Significance of Hepatic Fibrosis Indexes for Diagnosis of Infantile Cytomegalovirus Hepatitis

目的探讨血清透明质酸(HA)、层黏连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)和Ⅲ型前胶原(PCⅢ)、ALT和AST在婴儿巨细胞病毒(CMV)肝炎临床诊断中的意义。方法应用化学发光法对60例CMV肝炎患儿(病例组)及30名健康婴儿(健康对照组)血清HA、LN、Ⅳ-C、PCⅢ、ACT和AST水平进行检测,并对二组婴儿血肝纤维化指标进行比较;同时按临床特点及肝功能将病例组分为急性淤胆型肝炎组(A组)和无黄疸型肝炎组(B组),并对A、B二组患儿血清肝纤维化指标进行比较。结果CMV肝炎患儿血清中HA、Ⅳ-C、PCⅢ、ACT和AST水平均有不同程度升高,与健康对照组比较差异显著;但二组LN水平比较无显著性差异。A组患儿血清HA、Ⅳ-C、PCⅢ、ALT、AST水平均显著高于B组;A、B二组患儿LN水平比较无显著性差异。结论血清肝纤维化指标HA、LN、Ⅳ-C、PCⅢ水平与CMV肝炎密切相关;在不同临床类型CMV肝炎中,随病情严重程度增加而升高。联合检测血清肝纤维化指标对婴儿CMV肝炎的诊断、指导治疗及判断预后有一定参考价值。

Objective To investigate the significance of levels of serum hyaluronic acid （HA） , laminin （ LN）, collagentype Ⅳ（ Ⅳ- C ） , precollagen type Ⅲ（ PCⅢ ）, alanine aminotransferase （ALT） , aspartate aminotransferase （AST） for diagnosis of infantile cytomegalovirus （ CMV ） hepatitis. Methods The levels of HA, LN, Ⅳ - C, PC Ⅲ, ALT, AST in 60 cases of CMV hepatitis infants （ CMV hepatitis group ） and 30 cases of healthy infants （healthy control group） were determined by chemiluminescence methods. In addition, the CMV hepatitis group was divided into 2 groups by different clinical types （ group A and group B ）. Results The levels of HA, Ⅳ - C, PC Ⅲ, ALT and AST in CMV hepatitis group were higher significantly than those in healthy control group except the level of LN. And the levels of HA, Ⅳ- C, PC Ⅲ, ALT and AST in group A were higher significantly than those in group B, except the level of LN. Conclusions The levels of HA, LN, Ⅳ - C,PC Ⅲ are closely associated with infantile CMV hepatitis, and the levels of HA, Ⅳ - C, PC Ⅲ, ALT and AST in different clinical types of infantile CMV hepatitis are increased along with the development of the disease. Combined detection of the 4 above - mentioned indicators is useful for diagnosis on infantile CMV hepatitis.