慢性乙肝患者血清胆碱酯酶与肝纤维化血清标志物水平变化及临床意义

Changes and significance of serum cholinesterase level and liver fibrosis markers in patients with chronic hepatitis B

目的探讨慢性乙肝(CHB)和乙肝后肝硬化(LC)患者血清胆碱酯酶(ChE)与肝纤维化血清标志物透明质酸(HA)、人Ⅲ型前胶原(HPCⅢ)和Ⅳ型胶原(Ⅳ-C)水平的变化及其临床意义。方法用CX5型全自动生化分析仪测定233例CHB和87例LC患者血清ChE,用放射免疫法(RIA)测定HA、HPCⅢ、Ⅳ-C水平,并与50例健康体检者比较。结果CHB轻度、中度、重度和LCA级、B级、C级患者,血清ChE均显著低于正常对照组(P<0.01),且随病程进展,变化趋势的差异具有统计性意义(P<0.01);血清ChE活性与HA、HPCⅢ、Ⅳ-C水平均呈负相关(P<0.01)。结论血清ChE与HA、HPCⅢ、Ⅳ-C水平的变化,在CHB患者肝实质慢性病变和隐匿纤维化监测中具有重要临床意义。

Objective To investigate the changes and significance of serum cholinesterase（ChE）and liver fibrosis markers such as serum hyaluronie acid（HA）, human procollagen type Ⅲ （HPCⅢ）and type Ⅳ collagen（Ⅳ-C） lew els in patients with chronic hepatitis B（CHB）and liver cirrhosis（LC）. Methods The serum ChE was assayed by CX5 automatic biochemical in 233 cases of CHB and 87 cases of LC; the serum HA, HPCⅢ and Ⅳ-C were assayed by radioimmunoassay（RIA）. Then detection results of these markers were compared with 50 healthy people. Results The serum ChE concentrations in all patients with mild,moderate, severe CHB and LC of A, B and C class were significantly lower than those in the control group（P〈0.01） ,and the differences in the progression of trends also had the significance（P〈0.01）; the serum ChE negatively correlated with HA, HPC Ⅲ and Ⅳ-C（P〈0.01）. Conclusion The changes of serum ChE, HAHPCⅢ and Ⅳ-C level have the vital clinical significance in the monitoring of liver chronic pathological change and the concealment fibrosis in CHB patients.