肝病患者血清肝纤维化指标联合测定的临床意义

Clinical significance of combined determination of liver fibrosis indexes from liver disease patients′serum

目的探讨血清透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、层粘连蛋白(LN)和Ⅳ型胶原(CⅣ)联合检测在肝纤维化诊断中的应用价值。方法采用放射免疫分析法对81例肝病患者(肝炎组24例,肝硬化组39例,肝癌组18例)和40名健康体检者(对照组)同时测定血清HA、PCⅢ、LN和CⅣ等4项指标水平,比较各组肝病和对照组间4项指标的差异及各组肝病间HA水平的变化。结果各组肝病患者血清肝纤维化4项指标水平均高于对照组(P<0.05或P<0.01),肝硬化组织、肝癌组HA水平明显高于肝炎组(P<0.05,P<0.01),肝癌组HA水平高于肝硬化组(P<0.05)。结论血清HA、PCⅢ、LN、CⅣ联合检测对肝纤维化早期诊断和预后判断有重要临床意义。

Objective To explore the application value of combined detection of serum hyaluronic acid（HA） ,procollagen type Ⅲ（PCⅢ） ,laminin（LN） and collagen type Ⅳ（CⅣ） .Methods Immunoradiometric analysis was conclucted to detet the index levels of serum HA ,PC Ⅲ ,LN and C Ⅳ in 81 patients with liver disease（24 cases in hepatitis group ,39 cases in liver cirrhosis group ,18 ca-ses in liver cancer group） and 40 healthy adult（control group） .Then compared the differences of 4 indicators among groups .Results Four index levels of serum liver fibrosis from liver disease patients were higher than those of control group（P〈 0 .05 or P〈0 .01） ,HA level of liver cirrhosis group and liver cancer group were significantly higher than that in hepatitis group （P〈0 .05 ,P〈0 .01）HA level of liver cancer group was higher than that of liver cirrhosis group（P〈0 .05） ,liver cirrhosis was higher than hepati-tis group（P〈0 .05） .Conclusion Combined determination of the serum HA ,PCⅢ ,LN and CⅣ has importantly clinical significance in early diagnosis and prognosis of hepatic fibrosis .