血清肝纤维化指标判断肝硬化病情严重程度的初步探讨

To Explored The Judgeing Value the Severe Of Hepatocirrhosis of Serum Liver Fibrosis Index

目的了解血清透明质酸(HA)、Ⅲ型前胶原肽(PⅢP)、层粘连蛋白(LN)和Ⅳ型胶原(Ⅳ-C)等肝纤维化指标判断乙型肝炎肝硬化病情严重程度的价值。方法采用EISA法检测HA、PⅢP、LN、Ⅳ-C。肝硬化患者84例,根据Child-Pugh评分分为A、B、C三组并做两两比较。结果SNK法显示HA、PⅢP、LN、Ⅳ-C肝硬化各组与对照组相比差异有显著性(P<0.05)。HA在B级与A级间无差异(P>0.05),C级与A级间存在差异有显著性(P<0.05)。Ⅳ-C在C级与A级和B级、B级与A级间均存在差异(P<0.05)。HA、Ⅳ-C与胆碱酯酶(ChE)呈负相关(P<0.05),而与凝血酶原时间(PT)呈正相关(P<0.05)。结论HA、Ⅳ-C与肝硬化严重程度密切相关,可作为判断病情严重程度的指标。

Objectiye To investigate the clinical diagnosis value of serum hyaluronic acid（HA）, aminoterminal propeptide of type Ⅲ procollagen（PⅢP）, laminin（LN） and Ⅳ collagen （Ⅳ-C） with the severity of liver fibrosis and inflammation in cirrhosis. Methods A total of 84 patients with HBV-related cirrhosis were enrolled. All patients＇ serum fibrosis markers including hyaluronic acid （HA）, aminoterminal propeptide of type Ⅲ procollagen（PⅢP）, laminin（LN） and Ⅳ collagen （Ⅳ-C）were detected by linked immunosorbentassay （ELISA） method. The patient were divided into three group according their child-pugh grade, and compared with each other. Results Compared with control group, there were significant difference of HA, PⅢP, LN, Ⅳ-C in each child-pugh A, B, C group by SNK method. （ P〈0. 05）. Compared with hyaluronic acid of each group, there were on different between child-pugh A group and B group, but there were significant difference between child-pugh C group and A group（P〈0.05）. Compared with Ⅳ collagen of each other , there were significant difference by child-pugh A group, B group and C group. Ⅳ collagen were correlated negatively with cholineseterase（P〈0.05）. Hyaluronic acid（HA） and Ⅳ collagen （Ⅳ-C） were correlated positively with pro- thrombin time. Conclusion Hyaluronic acid（HA） and Ⅳ collagen （iv-C）were correlated with severe of cirrhosis and maybe one usefully independent predictor of prognosis.