肝纤维化血清标志物的临床应用评价

Clinical evaluation of serum markers of liver fibrosis

目的评价肝纤维化血清标志物透明质酸(HA)、Ⅲ型前胶原N端肽(PⅢNP)、Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)对肝纤维化诊断的应用价值。方法以肝穿病理学组织检查为金标准,采用化学发光法肝纤维化血清标志物定量检测试剂检测70例患者样本,计算血清标志物的灵敏度、特异性和准确性。结果与金标准相比,HA、PⅢNP、CⅣ、LN的灵敏度分别为83.3%、58.3%、66.7%、50.0%,特异性分别为77.3%、81.8%、72.7%、81.8%,诊断肝纤维化的准确性分别为81.4%、65.7%、68.6%、60.0%。结论血清HA、LN、PⅢNP、CⅣ水平与肝组织纤维化有良好的相关性,能较好地反映肝病的慢性化程度和肝纤维化活动水平及程度,在肝纤维化诊断中具有重要的应用价值。

Objective To evaluate serum markers Hyaluronic Acid （HA）, Amino-terminal Propeptide of Type Ⅲ Collagen （P Ⅲ NP）, Type ⅣCollagen （C Ⅳ ） and Laminin （LN） of liver fibrosis, which is a practical application for the diagnosis of liver fibrosis. Methods Histopathological examination of liver puncture be defined as golden standard, Seventy patients which were determined by golden standard were detected, which adopting by chmiluminescence reagent of Quantitative detection to Serum markers of liver fibrosis. Then, Sensitivity, specificity and accuracy were calculated and analysed to serum markers. Results Compared with golden standard, the sensitivity of HA, PmNP, CIV and LN was 83.3%, 58.3%, 66.7 and 50.0%; the specificity was 77.3%, 81.8%, 72.7% and 81.8%; the accuracy was 81.4%, 65.7%, 68.6% and 60.0%, respectively. Conclusion The levels of HA, PllI NP, C IV and LN in serum is well in correlation with liver fibrosis, which would well reflect the level of chronic patients and liver fibrosis. There is importantly actual application value on diagnosis of liver fibrosis.