慢性肝病病理分级、分期与血清学指标关系的初步研究

Relationship between Pathological Grading and Staging of Chronic Liver Diseases and Serum Parameters

目的：探讨血清学指标反映慢性肝病病理分级、分期的价值。方法：以肝穿刺活检病理学检查结果为标准，比 较２００例不同病理分级、分期慢性肝病病例血清学指标的差异。结果：不同病理分级、分期慢性肝病病例的天冬氨 酸转氨酶（ＡＳＴ）、白蛋白（Ａｌｂ）、Ａｌｂ／球蛋白（Ａ／Ｇ）比值、甲脂蛋白（ＡＦＰ）、γ－谷氨酰转肽酶（ＧＧＴ）、α２巨球蛋白（ＭＧ）、 ＰＧＡ积分、ＰＧＡＡ积分、ＰＧＡ指数和ＰＧＡＡ指数存在显著差异（Ｐ＜０．０５）；不同炎症分级病例的间接胆红素（ＳＩＢ）、 甘油三酯（ＴＧ）、高密度脂蛋白（ＨＤＬ）、碱性磷酸酶（ＡＬＰ）和凝血酶原时间（ＰＴ）亦存在显著差异（Ｐ＜０．０５）。不同肝纤 维化分期病毒性肝炎病例的ＡＳＴ、Ａｌｂ、Ａ／Ｇ比值、转铁蛋白（ＴＦ）、ＡＦＰ、ＧＧＴ、α２ＭＧ、ＰＧＡ积分、ＰＧＡＡ积分、ＰＧＡ 指数和ＰＧＡＡ指数存在显著差异（Ｐ＜０．０５）。结论：血清学指标ＡＳＴ、Ａｌｂ、Ａ／Ｇ比值、ＳＩＢ、ＴＧ、ＨＤＬ、ＡＬＰ、ＰＴ、 ＡＦＰ、ＧＧＴ、α２ＭＧ、ＰＧＡ积分、ＰＧＡＡ积分、ＰＧＡ指数和ＰＧＡＡ指数与肝脏炎症分级相关；ＡＳＴ、Ａｌｂ、Ａ／Ｇ比值、 ＡＦＰ、 ＧＧＴ、 α２ＭＧ、 ＰＧＡ积分、 ＰＧＡＡ积分?

Background/Aims: To study the value of serum parameters in reflecting pathological grading and staging of chronic liver diseases. Methods: According to the histologic examination of biopsy specimens, a comparable analysis of serum parameters in pathological grades and stages of 200 cases of chronic liver diseases was made. Results: There were significant difference in serum parameters including aspartate aminotransferase (AST), albumin (Alb), Alb/globulin (A/G) ratio, serum indirect bilirubin (SIB), triglycerides (TG), high density lipoprotein (HDL), alkaline phosphatase (ALP), prothrombin time (PT), α-fetoprotein (AFP), γ-glutamyl transpeptidase (GGT), α2-macroglobublin (MG), PGA score, PGAA score, PGA index and PGAA index among pathological grades (P<0.05), in serum parameters including AST, Alb, A/G ratio, AFP, GGT, α2MG, PGA score, PGAA score, PGA index and PGAA index among pathological stages (P<0.05) and in serum parameters including AST, Alb, A/G ratio, transferrin (TF), AFP, GGT, α2MG, PGA score, PGAA score, PGA index and PGAA index among pathological stages of chronic viral hepatitis (P<0.05). Conclusions: Serum parameters including AST, Alb, A/G ratio, SIB, TG, HDL, ALP, PT, AFP, GGT, α2MG, PGA score, PGAA score, PGA index and PGAA index were correlated with the pathological grades; AST, Alb, A/G ratio, AFP, GGT, α2MG, PGA score, PGAA score, PGA index and PGAA index were correlated with the pathological stages. TF correlates with the pathological stages of chronic viral hepatitis. This indicates that some serum parameters might reflect the pathological grading and staging of chronic liver diseases.