血吸虫病与慢性病毒性肝炎血清肝纤维化指标的比较

A comparative study on serum indexes of liver fibrosis between schistosomiasis Japonica and chronic viral hepatitis

目的 用放射免疫法 (RIA)测定血吸虫病肝纤维化及慢性病毒性肝炎肝纤维化患者血清(肝 )纤维化指标 ,探讨其临床意义。方法 对 438例晚血 (其中 5 2例切脾作肝活检诊断者 )和 2 6 0 0例慢性肝炎患者 (其中 2 80例作肝活检病理组织诊断者 ) ,用RIA法测血清纤维化指标透明质酸 (HA)、Ⅲ型前胶原 (PCⅢ )、Ⅳ型胶原 (Ⅳ -C)和层连蛋白 (LN)。作肝脏病理组织学检查及肝功能与乙、丙肝标志检测。结果 晚血患者血清纤维化指标介于轻与中度慢性肝炎之间 ,而肝纤维化介于中度与重度肝炎之间 ,晚血炎症活动程度不明显。结论 血清纤维化指标不仅与肝纤维化程度 ,且与肝炎后活动程度有关 ,这些指标均有助于血吸虫病肝纤维化与慢性肝炎的鉴别 ,提示晚血抗肝纤维化治疗的必要性。

Objective To explore the clinical meanings of serum indexes for liver fibrosis caused by schistosomiasis Japonica and chronic viral hepatitis. Methods Serum indexes of liver fibrosis, including hyaluronic acid (HA), precollagen-Ⅲ (PCⅢ), collagen-Ⅳ (CⅣ) and laminin(LN), were measured by RIA in 438 cases of advanced schistosomiasis Japonica liver fibrosis and 2600 cases of chronic viral hepatitis. Results Compared with the indexes of chronic hepatitis, the serum levels of liver fibrosis indexes for advanced schistosomiasis Japonica was between those of mild and moderate chronic viral hepatitis, while the degree of hepatic fibrosis between those of moderate and severe chronic viral hepatitis. There was little inflammation in advanced schistosomiasis Japonica liver fibrosis. Conclusion Serum indexes of liver fibrosis associate with the degree of activity of post-hepatitis as well as the degree of liver fibrosis. The indexes are useful for identification the liver fibrosis from schistosomiasis Japonica and chronic viral hepatitis