多项血清学指标在肝病诊断中的临床应用

Clinical Application of Six Serological Indexes in Diagnosis of Hepatic Diseases

目的：探讨６ 项血清学指标联合检测在病毒性肝纤维化病程发生、发展及治疗过程中的临床意义。方法：利用 Ｒ Ｉ Ａ 法对肝硬化肝癌组（８２ 例） 、慢性病毒性肝炎组（１６５ 例） 和正常对照组（９３ 例） 进行血清转化生长因子α（ Ｔ Ｇ Ｆα） 、甘胆酸（ Ｃ Ｇ） 、透明质酸（ Ｈ Ａ） 、Ⅲ型前胶原（ ＰⅢ Ｐ） 、Ⅳ型胶原（ ＣⅣ） 和层连蛋白（ Ｌ Ｎ） 含量测定。统计学处理采用ｔ 检验。结果：肝硬化肝癌患者６ 项指标与正常对照组比较，差异有显著意义（ Ｐ＜ ０ ．０６） ，而与肝炎组比较， Ｃ Ｇ 含量无显著差异（ Ｐ＞ ０ ．０５） ， Ｔ Ｇ Ｆα、 Ｈ Ａ、 ＰⅢ Ｐ、 ＣⅣ和 Ｌ Ｎ含量明显升高（ Ｐ＜ ０ ．００６） 。结论： Ｃ Ｇ 对于肝炎和肝硬化肝癌的鉴别诊断无特异性， 但与病情变化密切相关； Ｔ Ｇ Ｆα、 Ｈ Ａ、 ＰⅢ Ｐ、 ＣⅣ和 Ｌ Ｎ 检测对两种肝病的诊断、病情观察、判定疗效及预后有重要意义。

Objective:The investigation was designed to explore the clinical significance of six serological indexes in diagnosis of hepatic diseases during the course of clinical development and treatment.Methods:Contents of serum transform growth factor α (TGF α ),cholyglycine(CG),hyaluronic acid(HA),procollagen type Ⅲ(PⅢP),type Ⅳ collagen(CⅣ),laminin(LN) were detected by radioimmunoassay in 82 cases of hepatic sclerosis,165 cases of hepatitis and 93 controls. The results were analyzed by t ?test. Results:Compared with control group, contents of all 6 indexes in hepatic sclerosis have significant difference ( P <0.006).Compared with hepatitis group, contents of CG have no significant difference ( P >0.05), and the contents of the others were increased significantly( P <0.006). Conclusions:The levels of CG have no specificity for distinguishing hepatic sclerosis from hepatitis, but relate to clinical development. The other indexes are of reference value for distinguishing one from the other in diagnosis,observation of patient condition,determination of curative effect and prognosis.