再评价血清学指标诊断慢性乙肝肝纤维化程度的价值——附83例肝穿病例

Reevaluation of diagnostic value of serum fibrosis markers to liver fibrosis staging in patients with chronic hepatits B

目的评价血清肝纤维化指标诊断肝纤维化程度的价值及意义。方法选择83例慢性乙型肝炎患者进行肝组织穿刺,同时进行血清肝纤维化指标Ⅲ型前胶原肽(PⅢP)、透明质酸(HA)、层粘连蛋白(LN)及Ⅳ型胶原(CⅣ)的检测,应用偏相关分析肝纤维化血清学指标与肝组织纤维化程度及炎症程度的关系。结果肝组织炎症和纤维化程度有显著相关性(γ=0.415,P=0.000);肝组织炎症和血清PCⅢ、HA及CⅣ有显著相关性(γs=0.389,P=0.000;γs=0.327,P=0.003;γs=0.303,P=0.005),肝组织纤维化程度和血清纤维化指标CⅣ、HA有相关性(γP=0.354;γP=0.434,P=0.000)。结论运用血清学肝纤维化指标评价肝组织纤维化程度时应考虑肝组织炎症程度对肝纤维化指标的影响。

Objective To evaluate the diagnostic value of serologic markers for the staging hepatic fibrosis. Methods Eighty- three liver biopsies of chronic hepatitis B patients were reviewed histopathologically. Serum sample for fibrosis markers test were collected simuhaneonsly half a month before or after the biopsy. The correlations between the results were assessed. Results The inflammatory grading was significantly correlated with fibrosis staging （γs =0. 415, P = 0. 000） and serum CIV ,PIIIP,HA（γs=0. 389,P =0. 000 ;γs =0. 327,P =0. 003 ;γs =0. 303 ,P =0. 005） , fibrosis staging was significantly correlated with serum CIV, HA（ γs = 0. 354,γp ： 0. 434, P = 0. 0000）. Conclusion The influence of liver inflammation to serum fibrosis markers must be considered when the liver fibrosis staging is evaluated by these markers.