肝病患者血清前Ⅲ型胶原和透明质酸检测的临床意义

Clinical significance of serum PⅡP and HA in patients with hepatic diseases

目的 探讨肝病患者血清前Ⅲ型胶原(PⅢP)和透明质酸(HA)的含量变化及其意义。方法 放射免疫法检测201例肝病患者、30例正常人血清的PⅢP和HA含量,同时检测慢性肝炎组患者血液生化指标。结果 与健康对照组比较,除脂肪肝组外,急性肝炎、慢性肝炎轻中重度三型、肝炎后肝硬化和肝癌各组的PⅢP和HA含量均明显升高,差异有统计学意义(P<0.01),其中PⅢP在慢性肝炎(重度)为最高,HA在肝炎后肝硬化组为最高。慢性肝炎组随着病情的加重PⅢP、HA、γ-球蛋白和胆汁酸含量随之增高,而血清白蛋白(A)、白/球比例(A/G)和纤维蛋白原(FIB)水平逐渐下降,凝血酶原时间(PT)则延长。其中PⅢP、HA在轻度慢性肝炎患者就有明显改变。结论 血清PⅢP、HA在多种肝病中均有显著升高,在慢性肝炎轻型,其含量变化已很明显地高于正常值,较生化指标能更敏感地反映肝细胞损害程度。检测其含量可反映肝脏损害程度、炎症活动程度及纤维化增生程度,有助于慢性肝炎、肝硬化和肝癌的诊断,尤其对慢性肝炎轻型的诊断有较好的临床价值。

Objective To observe the changes of serum type Ⅲprocollagen(PⅢP) and hyaluronic acid (HA) and evaluate their clinical significances in patients with hepatic diseases. Methods Serum PⅢP and HA were detected by radioimmunoassay in 201 patients with hepatic diseases and in 30 healthy people, several serum biochemical parameters were detected simultaneously in patients with chronic hepatitis. Results Compared with normal control group, serum PⅢP and HA were significantly increased in patients with acute hepatitis,chronic hepatitis (mild,moderate and severe) ,hepatic cirrhosis and hepatic cancer. The highest level of serum PⅢP and HA were found in patients with chronic hepatitis (severe type) and hepatic cirrhosis. In patients with chronic hepatitis, as the disease progressed, serum PⅢP and HA increased gradually, serum albumin, albumin/globulin ratio, and fibrinogen decreased, prothrombin time prolonged. There were significant changes in serum level of PⅢP and HA in patients with mild chronic hepatitis. Conclusion Serum PⅢP and HA are significantly increased in several kinds of hepatic diseases. The serum PⅢP and HA in patients with mild chronic hepatitis was higher than normal upper limit. PⅢP and HA are more sensitive than the other serum biochemical parameters in reflecting the severity of hepatic damage. Detection of serum PⅢP and HA are helpful in assessing the severity of hepatic damage, degree of inflammatory activity, hepatic fibrosis and in diagnosing chronic hepatitis, hepatic cirrhois and hepatic cancer, in particular, in diagnosing mild chronic hepatitis.