血清透明质酸、Ⅲ型前胶原、Ⅳ型胶原水平对肝组织纤维化的诊断意义

Diagnostic value of serumal hyalurionic acid , type Ⅲ procollagen and type Ⅳ collagen on the degree of hepatic fibrosis

目的研究血清纤维化指标透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(ⅣC)水平对肝组织纤维化不同阶段诊断的临床应用价值。方法用放射免疫法(RIA)检测85例慢性乙型肝炎(CHB)患者血清HA、PCⅢ及ⅣC水平,同时行肝组织活检,对肝组织进行炎症分级及纤维化分期。分析上述血清指标水平与肝组织分级和分期之间的关系。结果上述指标水平均与慢性肝炎发展的阶段一致,在慢性重度与肝硬化阶段处于最高水平,与肝组织炎症坏死及纤维化程度亦一致,在炎症分级G4、纤维化分期S4水平最高。血清HA、PCⅢ、ⅣC水平与肝组织炎症坏死和纤维化程度均呈正相关。结论血清HA、PCⅢ及ⅣC可以作为反映肝纤维化程度的指标之一。

Objective To study the clinical applied value of the serumal hepatic fibrosis indexes on diagnosing the degree of hepatic fibrosis in different phrase including hyalurionic acid （HA）, type Ⅲ procollagen （PCⅢ） and type Ⅳ collagen （Ⅳ.C）. Methods To analyze the relation of serumal indexes （HA, PC Ⅲ, Ⅳ .C）, detected by radioimmunoassay （RIA）, and hepatic phlogistic grades indexes and fiberized stages indexes, detected by liver biopsy, of 85 cases with chronic hepatitis B （CHB）. Results The serumal indexes accord with CHB developmental stages, culminating at chronic severity and hepatic cirrhosis phrase, and accord with the degree of hepatic phlogistic grades and fiberized stages, culminating at grades 4 and stages 4. The serumal indexes have positive correlation with the degree of grades and stages. Conclusion The serumal indexes （HA, PCⅢ, Ⅳ.C） possess significant diagnostic value on the degree of hepatic fibrosis.