血清IV型胶原对肝纤维化临床价值的初步探索

CLINICAL EVALUATION OF SERUMCOLLAGEN TYPE IV IN DIAGOSING LIVER FIBROSIS

用一步夹心酶免疫法检测１１４例各种肝病病人、３０例非肝病病人及３０名正常对照者的血清ＩＶ型胶原（ＣＩＶ）水平，并与Ⅲ型前胶原（ＰＣⅢ）及透明质酸（ＨＡ）比较。结果表明：慢性活动性肝炎、肝硬化及原发性肝癌组的血清ＣＩＶ水平同ＰＣⅢ、ＨＡ一样明显升高；３项指标与肝穿刺活检所确定的纤维化程度呈显著正相关，但３者相互间的相关性并不明显；ＣＩＶ、ＰＣⅢ、ＨＡ对肝纤维化的敏感性分别为７３．９％，６７．４％，６７．４％；特异性分别为９５．７％，９１．３％，１００．Ｏ％；诊断准确性分别为８１．２％，７５．４％，７８．３％。单独检测以ＣＩＶ较好，对肝纤维化的早期诊断价值优于ＰＣⅢ及ＨＡ；联合检测以ＣＩＶ与ＰＣⅢ联合较为理想，其敏感性及诊断准确性均达９０．Ｏ％以上，特异性亦可达８７．Ｏ％。

erum collagen type IV(CIV) levels determined by one step sand wich EIA kit were compared with the serum procollagen type Ⅲ(PCⅢ)and hyaluronic acid ( HA )in 114 patients with various liver di- seases, 30 patients without liver diseases(NL)and 30 controls. Results:serum CIV was significantly in- creased in chronic active hepatitis, liver cirrhosis and primary hepatic carcinoma. So were PCⅢ and HA. Serum CIV、PCⅢ and HA were found to be closely related to the degree of fibrosis in 6 9 patients' liver biopsy studies,but no correlation could be found between these 3 markers,The sensitivity of CIV,PCⅢ,HA in detecting liver fibrosis were 73.9%,67.4%,67.4%with specificity of 95.7%, 9l.3%,100.0% respectively.The early diagnostic value of CIV is better than PCⅢ and HA;their combination could fur-ther raise the diagnostic sensitivity to more than 90.0%。