摘要
目的 探讨慢性肝炎患者血清纤维化指标 [血清透明质酸 (HA)、Ⅲ型前胶原 (PCⅢ )、Ⅳ型胶原 (Ⅳ C)、层黏蛋白 (LN) ]的临床实用价值。方法 对 2 6 0 0例慢性肝炎轻、中、重度患者 ,用放免法检测血清HA、PCⅢ、Ⅳ C、LN ,并对其中的 2 80例进行肝穿刺标本病理组织学检查 ,作肝脏炎症活动度分级、肝纤维化程度分期及慢性肝炎病理组织学分度 ,探讨它们与纤维化指标之间关系。结果 2 6 0 0例轻、中、重度慢性肝炎患者 ,4项指标之间均有明显差异 (P <0 0 1)。这 4项指标均与肝脏炎症活动度分级、肝纤维化程度分期及慢性肝炎的分度有关。相关系数HA分别为 0 5 44、0 5 48和 0 46 8;PCⅢ为 0 495、0 42和 0 335 ;Ⅳ C为 0 40 6、0 40 4和 0 412 ;LN为 0 2 14、0 2 0 4和 0 184。结论 血清学检测对慢性肝炎的诊断有较大的临床指导作用 ,但对某一患者评价这些指标的意义时 ,应结合肝功能检查、B超检查及临床表现 ,作全面分析。
Objective To find the relationship between serum levels of hyaluronic acid (HA) , type Ⅲ procollagen (PCⅢ), laminin(LN), type Ⅳ collagen (Ⅳ C) and hepatic fibrosis as well as to determine their value in clinical practice Methods 2 600 serum samples from chronic hepatitis patients were tested with RIA for fibrosis indexes assays including HA, PCⅢ, LN and Ⅳ C 280 of the patients with serum samples taken had liver biopsy performed and the biopsy material was examine pathomorphologically Fibrosis indexes were compared according to inflammation grade, fibrosis stage and chronic hepatitis degree Results In the 2 600 serum samples from chronic hepatitis patients, fibrosis indexes (including HA, PCⅢ, LN and Ⅳ C ) had significant correlation with inflammation grade, fibrosis stage and the degree of chronic hepatitis( P <0 01) The relating indexes to HA were 0 544, 0 548, 0 468 respectively, to PCⅢ 0 495, 0 424, 0 335 respectively, to LN 0 214, 0 204, 0 184 and to Ⅳ C were 0 464, 0 404, 0 412 respectively Conclusion Serum fibrosis indexes are fairly well correlated with the inflammation grade, fibrosis stage and the degree of chronic hepatitis However, as diagnostic markers, they must be combined with liver function, ultrasonography and clinical features.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2001年第7期448-451,共4页
Chinese Journal of Internal Medicine
