男性肝纤维化患者雌激素水平变化的临床意义

Change of serum levels of estrogen and clinical significance in the male patients with fibrosis of liver

目的探讨男性肝纤维化患者雌激素水平的变化以及与血清透明质酸(HA)、Ⅲ型前胶原肽(PⅢNP)、Ⅳ型胶原(Ⅳ-C)、层粘连蛋白(LN)及肝功损害的关系。方法采用酶联免疫法检测31例健康男性、26例男性慢性肝炎和34例男性肝硬化患者的HA、Ⅳ-C、PⅢNP、LN;同时采用放免法检测上述对象的雌酮(E1)、雌二醇(E2)、雌三醇(E3)。结果肝炎组以及肝硬化组的HA、PⅢNP、Ⅳ-C和LN明显高于正常组(P<0.05或P<0.01),且肝硬化组明显高于肝炎组(P<0.05或P<0.01)。肝炎组以及肝硬化组的E1、E3明显高于正常组(P<0.05或P<0.01),且肝硬化组明显高于肝炎组(P<0.05或P<0.01)。三组的E2水平逐渐增高,但是无显著性差异(P>0.05)。E1、E3浓度与HA、Ⅳ-C呈正相关,E2与两种指标均无明显相关性。结论肝纤维化患者存在不同程度的雌激素水平升高,并且雌酮、雌三醇的升高程度与肝硬化肝功能受损程度有明显关系,测定雌激素水平变化,可以作为临床判断预后、疗效的一个指标。

Objective To explore the relationship between serum levels of estrogen and hyalurnic acid, procollagen -Ⅲ, collagen - Ⅳ and layer mucigen and severity of liver dysfunction in the male patients with fibrosis of liver. Methods HA, P Ⅲ NP,Ⅳ - C, LA were measured by ELISA and E1, E2, E3 were measured by radioimmunoassay in 34 cases cirrhosis , then compared with 26 chronic hepatitis and 31 cases normal. Results In chronic hepatitis group and cirrhosis group ,the hyalurnic acid, HA, PⅢNP, Ⅳ -C and LN are significantly higer than control group（ P 〈 0. 05 or P 〈 0.01 ）. In chronic hepatitis group and cirrhosis group , E1 and E3 levels are significantly higer than control group. That of cirrhosis group higer than hepatitis group. No difference was found in E2 level among three groups（ P 〉0. 05 ）. E1 level and E3 level are correlated positively with HA, Ⅳ - C. E2 levd are not correlated with them. Conclusion Hepatocirrhosis has varying amounts of disorder in levels of estrogen in serum , depending on liver function lesion gravity , the determination of above hormone could be deserved as a standard for clinical state of illness.