肝脏纤维化血清标志物与肝脏病理的对照研究

Comparative studies of serum marker substances of liver fibrosis and liver pathology

目的:探讨慢性肝病患者纤维化血清透明质酸(HA)、层粘蛋白(LN)、Ⅳ型胶原(IVC)、Ⅲ型前胶原(PⅢP)与肝组织病理检查即炎症活动程度和纤维化程度之间的关系.方法:对80例慢性肝病患者及30例正常对照者采用放射免疫法检测血清肝纤维化四项指标;对80例慢性肝病患者行肝组织穿刺作肝脏病理炎症分级和纤维化分期;然后将两者进行比较分析.结果:血清纤维化四项指标由G1～G4、S0～S4依次升高,但在各级及各期间升幅不完全一致;在反映肝脏炎症活动程度方面以HA上升最早,级间升幅较大;在反映肝组织纤维化程度方面PⅢP在S2期就明显升高;血清HA、LN、IVC、PⅢP水平与肝病分期及分级呈正相关.结论:透明质酸(HA)在反映肝脏炎症程度方面较敏感,Ⅲ型前胶原(PⅢP)在反映肝脏纤维化程度方面较敏感.肝纤维化血清学四项指标对了解肝脏炎症及纤维化程度有较高的临床价值.

Objective： To investigate the relationship of serum hyaluronie acid （HA）, laminin （LN）, type Ⅳ collagen （IVC） , procollagen-Ⅲ- peptide （PⅢP） and liver inflammation and fibrosis, to evaluate its valuation in liver fibrosis noninjury check preliminarily .Methods：Liver biopsy was performed in 80 pations with chronic hepatitis B for histological examination. Serum HA, LN, IVC, P Ⅲ P were tested by EIA.Results： Serum HA, LN, IVC and P Ⅲ P increased with inflammatory grades from G1 to G4 and the fibrosis stages from S0 to S4, respectively. In inflammatory grades HA increased first and with a higher degree than LN, IVC and PnlP did. In fibrosis stages P Ⅲ P obviously increased from the stage S2 than HA,LN and IVC .Serum HA,LN,IVC and P Ⅲ P were positive correlated with the degrees of liver inflammation and stages of liver fibrosis. Condttsion：HA was more sensitive than LN , IVC and P Ⅲ P in liver irflammation, P Ⅲ P was more sensitive than HA, LN and IVC in liver fibrosis. Serum HA, LN, IVC and P Ⅲ P had more useful clinical valuation in liver inflammation and liver fibrosis.