肝纤维化指标和微量元素联合检测用于肝纤维化诊断的研究

Study on combined application of indicators of hepatic fibrosis and microelements assay in hepatic fibrosis

目的研究慢性肝病患者血中微量元素锌、铁与肝纤维化指标(透明质酸、层黏连蛋白、Ⅲ型前胶原、Ⅳ型胶原)的关系。方法 43例慢性肝炎患者、54例肝硬化患者、45例健康体检者被纳入研究,抽取空腹静脉血,采用原子吸收法检测锌、铁;应用酶联免疫法检测肝纤维化指标。结果与正常对照组相比,慢性肝炎组患者血清锌含量降低,铁含量增高,其差异有统计学意义(P<0.05)。与慢性肝炎组相比,肝硬化组患者血清锌和铁含量均降低,差异有统计学意义(P<0.05)。与正常对照组相比,慢性肝炎组和肝硬化组患者肝纤维化指标(透明质酸、层黏连蛋白、Ⅲ型前胶原、Ⅳ型胶原)明显增高(P<0.01)。随着病变进展,肝硬化组透明质酸和Ⅳ型胶原含量较慢性肝炎组进一步增高(P<0.05)。但是肝硬化组层黏连蛋白和III型前胶原含量与慢性肝炎组相比无明显变化。结论联合检测微量元素锌、铁含量及肝纤维化指标(透明质酸、层黏连蛋白、Ⅲ型前胶原、Ⅳ型胶原),对慢性肝病患者肝纤维化诊断具有重要临床意义,并可提示病变进展程度。

Objective To study on the relationship of serum zinc,iron and indicators（HA,LN,PCⅢ and Ⅳ-C） of hepatic fibrosis in different chronic hepatitis patients.Methods 43 patients with chronic hepatitis,54 patients with cirrhosis and 45 examination persons were enrolled.We drew their venous blood on empty stomach.Their serum levels of microelements were measured by atomic absorption spectrometer.Indicators of hepatic fibrosis were measured by ELISA.Results Compared with normal controls group,the levels of zinc in chronic hepatitis group were obviously decreased and the levels of iron were obviously increased（P〈0.05）.Compared with chronic hepatitis group,the levels of zinc and iron in cirrhosis group apparently decreased（P〈0.05）.Compared with normal controls group,the indicators of hepatic fibrosis（HA,LN,PCⅢ and Ⅳ-C） were apparently increased in both chronic hepatitis group and cirrhosis group（P〈0.01）.With the development of hepatic disease,the levels of HA and Ⅳ-C in cirrhosis group were apparently more than in hepatitis group（P〈0.05）.However,the levels of LN and PCⅢ had not significant difference in cirrhosis group contrast to chronic hepatitis group.Conclusion The combination detection of zinc,iron and indicators of hepatic fibrosis（HA,LN,PCⅢ and Ⅳ-C） have great clinical significance on diagnosis of hepatic fibrosis in chronic hepatitis patients.They may suggest the development of hepatic pathological change.