慢性肝炎患者血清纤维化指标影响因素的探讨

Analyses of factors influencing serum fibrotic markers in patients with chronic hepatitis

目的探讨影响慢性肝炎患者血清纤维化指标的因素。方法慢性肝炎78例,肝活检标本的病理分级和分期参照2000年全国病毒性肝炎及肝病学术会议修订的标准,血清透明质酸(hyaluronic acid,HA)、Ⅲ型前胶原(procollagen typeⅢ,PCⅢ)、层粘蛋白(laminin,LN)和Ⅳ型胶原(typeⅣcollagen,ⅣC)均采用放射免疫法检测。统计分析采用SPSS 11.5软件。结果患者年龄与血清HA和PCⅢ水平之间均呈显著正相关(P=0.000和0.048),与血清LN和ⅣC水平之间均无显著相关性(P=0.210和0.892);病理分级与血清HA、PCⅢ和ⅣC水平之间均呈显著正相关(P=0.033、0.005和0.002),病理分期与HA、PCⅢ、LN和ⅣC水平之间均呈显著正相关(P=0.000、0.000、0.031和0.000)。双因素协方差分析的结果显示,影响血清HA水平的因素依次分别为年龄和病理分期,其偏Eta平方分别为0.149和0.111;年龄以及病理分级和分期对血清PCIII水平无显著影响。双因素方差分析的结果显示,影响血清LN水平的因素依次分别为分期、分级与分期的交互作用和分级,其偏Eta平方分别为0.193、0.174和0.136;病理分级和分期对血清ⅣC水平无显著影响。结论年龄对血清HA水平有显著影响,病理分期对血清HA水平也可能有显著影响;年龄以及病理分级和分期对血清PCⅢ水平无显著影响;病理分级和分期对血清LN水平有显著影响;病理分级和分期对血清ⅣC水平无显著影响。

Objective To explore the factors influencing serum fibrotic markers. Methods 78 patients with chronic hepatitis were enrolled into present study. The pathological grading and staging of the liver biopsy samples were diagnosed according to the national standard revised in 2000. Serum fibrotic markers including hyaluronic acid （HA）, procollagen type Ⅲ （PCⅢ）, laminin （LN） and type Ⅳ collagen （ⅣC） were determined by RIA. SPSS11.5 software was used for statistical analyses. Results Serum HA and PCⅢ level were correlated significantly positively with the patients＇ age （P =0. 000 and 0. 048）, and serum LN and IVC level were not correlated significantly with the patients＇ age （P = 0. 210 and 0. 892）. Serum HA, PC Ⅲ and ⅣC levels were positively correlated with the pathological grading significantly （P = 0. 033, 0. 005 and 0. 002）;serum HA, PCⅢ, LN and ⅣC level were positively correlated with the pathological staging significantly （P = 0. 000, 0. 000, 0. 031 and 0. 000）. According to double variate analysis of covariance with interaction, the main factors influencing serum HA level were patients＇ age and pathological staging in file, the partial eta squared being 0. 149 and 0. 111 respectively; the patients＇ age, and the pathological grading and staging had no significantly influence on serum PCⅢ level. According to double variate analysis of variance with interaction, the main factors influencing serum LN level were the pathological staging, the interaction of pathological grading and staging, and the pathological grading, the partial eta squared being 0. 193, 0. 174, and 0. 136 respectively; the pathological grading and staging had no significantly influence on serum Ⅳ C level. Conclusions The patients＇ age has significant influence on serum HA level, and so did the pathological staging. The patients＇ age, and the pathological grading and staging have no significantly influence on serum PCⅢ level. The pathological grading and staging have significant influence on serum LN level. The pathological grading and staging had no influence significantly on serum ⅣC level.