肝纤维化血清指标与慢性肝炎肝组织炎症及纤维化的相关性

Correlation between serum markers for liver fibrosis and the degree of liver inflammation and fibrosis in patients with chronic hepatitis

目的探讨血清透明质酸（ＨＡ）、Ⅲ型前胶原（ＰＣⅢ）、层粘蛋白（ＬＮ）、ＩＶ型胶原（ＩＶ－Ｃ）等肝纤维化血清学指标与 慢性肝炎肝组织炎症活动度及纤维化程度的相关性。方法２７８例慢性肝炎患者经肝脏活检行常规病理检查，肝活检前 采血检测血清ＨＡ、ＰＣⅢ、ＬＮ、ＩＶ－Ｃ水平。结果肝组织纤维化程度与炎症活动度呈正相关；ＨＡ可反映中度以上慢性肝 炎炎症活动及肝纤维化，并与之呈正相关；肝脏存在纤维化时ＬＮ水平升高，与肝纤维化程度呈正相关；ＰＣⅢ、ＩＶ－Ｃ水 平升高与炎症活动度有关。结论血清ＨＡ、ＰＣⅢ、ＬＮ、ＩＶ－Ｃ水平均不同程度反映肝组织纤维化程度，可作为血清肝纤维 化检测指标；ＨＡ更能反映肝硬化发展趋势。

Objective To study the correlation between serum markers for liver fibrosis and the degree of liver fibrosis and inflammation in patients with chronic hepatitis B. Methods Liver biopsy was performed in 278 patients with chronic hepatitis B for pathological examination before which blood samples were collected from each patient to test the serum levels of hyaluronate, type Ⅲ procollagen, laminin and type IV collagen. Results Liver fibrosis and inflammation was positively correlated with each other (P<0.005). In patients with moderate liver inflammation and fibrosis, serum hyaluronate was above the normal level and was positively correlated to the degree of liver inflammation and fibrosis (P<0.05). In patients with chronic hepatitis B, serum levels of type Ⅲ procollagen, laminin and type IV collage increased apparently.Laminin was correlated to liver fibrosis (P<0.05), and type Ⅲ procollagen and type IV collagen were correlated to liver inflammation(p<0.05) Conclusions Serum hyaluronate, type Ⅲ procollagen laminin, and type IV collagen may indicate the state of liver fibrosis. Serum hyaluronate may be a useful marker for liver cirrhosis.