激活素A与肝纤维化的关系

The relationship between activin A and hepatic fibrosis

目的探讨慢性乙型肝炎(CHB)患者血清激活素A(activin A,ACTA)与肝细胞损伤、肝纤维组织增生的关系。方法采用酶联免疫吸附试验(ELISA)测定118例慢性乙肝患者(其中慢性轻度35例,中度30例,重度28例,肝硬化25例)血清ACTA及透明质酸(HA)、四型胶原(ⅣC)、层粘连蛋白(LN)含量,并分析其相关性。其中35例进行肝活检,行苏木素染色(HE),应用多媒体彩色图文分析系统对肝内胶原纤维进行定量分析。同时测定肝功能(TBil、ALT、GLB),进行相关性分析。结果慢性乙肝轻、中、重度及肝硬化(LC)患者血清ACTA水平依次升高,明显高于对照组(P<0.01或P<0.05)。除慢性轻度组LN外,其他各组血清ACTA与HAI、VC、LN呈明显正相关(P<0.01或P<0.05)。ACTA与肝功能指标(TBil、ALT、GLB)明显正相关(P<0.01或P<0.05)。结论ACTA在慢性肝病纤维化发病机制中起重要作用。血清ACTA的检测可做为慢性乙肝患者肝纤维化程度和肝细胞受损程度的判断依据。

Objective To explore the relationship between the serum activin A and hepatocyte damage and liver fiber hyperplasia in patients with chronic liver diseases. Method The serum activin A（ACTA） was assayed by ELISA in 118 patients with chronic liver diseases. Of them, 35 were given liver biopsy, and the liver collagen fiber was quantitatively analysed by multimedia chromatic glossary analytical system, at the same time, the liver function（TBil,ALT,GLB） was examined. Results The serum activin A in patients with chronic mild, mode.st and severe hepatocirrhosis increased in order and was obviously higher than in control group（ P〈 0.01 or P〉0.05）. Activin A was positively correlated to hyaloplasm acid, type IV precollagen laminim （P〈0.01 or P〉0.05）. The serum ACTA level was positively correlated to the level of liver tissue fibrosis and amounts of collagen fiber（ P 〈 0.01 or P 〉 0.05）. Conclusion ACTA plays an important role in the pathogenesis of liver fibrosis. The level of liver fibrosis and hepatocyte damage in chronic liver disease can be estimated according to the assay of serum ACTA.