摘要
目的探讨血清肝纤四项对肝脏纤维化的临床诊断价值。方法回顾性分析157例确诊的慢性乙型肝炎肝穿刺病理活检病例,同时检测血清肝纤四项:透明质酸(HA)、Ⅲ型前胶原肽(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、层黏连蛋白(LN)的水平。将肝纤四项与肝组织纤维化病理分期进行对照分析。结果 HA、PCⅢ、Ⅳ-C、LN与肝组织纤维化病理分期的相关系数(r)分别为0.478(P<0.01)、0.175(P<0.05)、0.155(P<0.05)、0.198(P<0.05)。四个指标水平均随着肝组织纤维化程度的加重呈上升趋势,且HA的S3、S4期水平与S1期、S4期水平与S1、S2、S3期比较差异有统计学差异(P<0.05),PCⅢ的S3、S4期水平与S1期比较差异有统计学差异(P<0.05)。以S4期作为早期肝硬化诊断标准时,通过ROC曲线分析HA、PCⅢ、Ⅳ-C、LN的曲线下面积分别为0.745、0.553、0.538、0.583。敏感度:LN>Ⅳ-C>PCⅢ>HA;特异度:HA>PCⅢ>LN>Ⅳ-C。结论肝纤四项对慢性乙型肝炎肝组织纤维化程度有一定的诊断价值。
Objective To discuss the clinical value of four serum fibrosis indexes in the diagnosis of liver fibrosis in patients with chronic hepatitis B. Methods Pathological analysis of liver biopsy and serum samples detected for four fibrosis indexes including HA,PC-Ⅲ,Ⅳ-C and LN from 157 cases of chronic hepatitis B patients were analyzed retrospectively. The four indexes are comparatively analyzed according to the liver pathological fibrosis stage. Results HA,PCⅢ,Ⅳ-C,LN were correlated positively with stage of fibrosis（ r = 0. 478,P〈0. 01; r = 0. 175,P〈0. 05; r = 0. 155,P〈0. 05; r = 0. 198,P〈0. 05）. All the four indexes showed upward trend according to the severity of liver fibrosis,and there was statistically significant difference of HA level between S3,S4 and S1（ P〈0.05）,between S4 and S1,S2,S3（ P〈0.05）. When S =4 as positive criteria for diagnosing early liver cirrhosis,ROC analysis showed that the AUCs of HA,PC-Ⅲ,Ⅳ-C,LN were 0. 745,0. 553,0. 538,0. 583,respectively. The sensitivity LN〉 Ⅳ-C 〉PCⅢ 〉HA,the specificity HA〉 PCⅢ 〉LN 〉Ⅳ-C. Conclusion These four serum liver fibrosis indexes have a certain value for diagnosing the stage of liver fibrosis in chronic hepatitis B patients.
出处
《临床合理用药杂志》
2014年第32期9-10,共2页
Chinese Journal of Clinical Rational Drug Use
