血浆TGF-β1测定在肝纤维化和炎症分期中的临床实用价值

Practical Value in Clinic of Plasma TGF-β1 Level in Hepatic Tissue Fibrosis and Inflammation

目的探讨外周血浆转化生长因子β1(TGF-β1)检测对判定肝组织炎症分级和纤维化分期的临床意义。方法慢性乙型肝炎72例,早期肝硬化17例,正常对照组36例。肝组织标本采用Masson三色染色及Gordon-Sweets浸银染色判定炎症分级及纤维化分期,采用多媒体图像系统对Masson染色标本进行胶原定量测定,分析各纤维化分期及胶原纤维含量对应的血浆TGF-β1水平。结果慢性乙型肝炎和早期肝硬化患者血浆TGF-β1水平显著高于正常血浆对照组,TGF-β1水平随纤维化分期从S0～S4逐步升高,不同纤维化分期间差异显著(P<0.05),TGF-β1水平与肝组织胶原含量呈正相关(r=0.756,P<0.01),与肝组织不同炎症分级无相关性(r=0.165,P>0.05)。结论动态观察血浆TGF-β1变化有助于判定慢性乙型肝炎和早期肝硬化肝组织纤维化程度。

Objective To discuss the practical value of peripheral plasma transforming growth facotor β1 （TGF-β1 ） in hepatic tissue inflammation grading and fibrosis staging. Methods 72 cases with chronic B viral hepatitis, 17 cases with earlier hepatic cirrhosis and 36 normal cases as a control group were used in this study. Inflammation grades and fibrosis stages of hepatic tissue sample were judged respectively by Masson trichrome method and Gordon-Sweets sliver staining. Collogen content of Masson-stained samples was measured by multimedia image system. Results Plasma TGF-β1（ng/ml）levels in patients with chronic B viral hepatitis and earlier period hepatic cirrhosis were much higher than those of the normal-control group and increased with hepatic tissue fibrosis progression from S0-S4. There was a significant difference between different fibrosis stages （P 〈 0.05 ） and a positive correlation between TGF-β1 level and hepatic tissue collogen content （r = 0.756,P 〈 0.01 ）. There was no obvious correlation between TGF-β1 leveland different hepatic tissue inflammation grades （r = 0.165,P 〉 0.05）. Conclusion Plasma TGF-β1 level in patients with chronic B viral hepatitis and earlier period hepatic cirrhosis can help to judge the degree of hepatic tissue fibrosis.