肝纤维化、r-谷氨酰基转移酶和凝血酶原时间联合检测的临床应用

Clinical application of combined detection of liver fibrosis,r-glutamyltransferase and prothrombin time

目的通过对各型肝病患者血清肝纤维化四项和r-谷氨酰基转移酶(GGT)和凝血酶原时间(PT)的检测与分析,判断各型肝病患者纤维化指标。方法对住院95例各型肝病患者进行肝纤维化四项即透明质酸(HA)、Ⅲ型前胶原肽(PⅢNP)、Ⅳ型胶原(ⅣC)、层黏连蛋白(LN)及GGT和PT检测。结果中重度慢性肝病患者肝纤维四项升高明显,与对照组比较差异有统计学意义(P<0.01);急性肝炎PT和GGT指数无明显的改变;慢性轻度肝炎时,肝纤维四项及PT和GGT均轻度升高。中重度慢性肝炎患者中,肝纤维四项有较高的灵敏度,HA的灵敏度较高,为肝纤维化最敏感的诊断指标。结论通过肝纤维化四项及血清GGT和PT的联合检测,结果可作为判断慢性肝病患者肝纤维化的常规指标,为临床药物抗肝病纤维化治疗提供依据。

Objective To detect and analyze serum liver fibrosis four items,r- glutamyltransferase（ GGT） and prothrombin time（ PT） in patients with different liver diseases,so as to evaluate the fibrosis indexes in patients with liver diseases. Methods The four hepatic fibrosis： hyaluronic acid（ HA）,type Ⅲ procollagen（ PⅢNP）,collagen Ⅳ（ ⅣC） and various adhesion proteins（ LN） as well as GGT and PT of 95 hospitalized patients with different liver diseases were detected. Results In acute hepatitis,serum HA,LN,PⅢNP,ⅣC slightly increased,and compared with the control group,the difference had statistical significance（ P 0. 01）; there was no significant change in PT and GGT index in patients with acute hepatitis; HA,LN,PⅢNP,ⅣC in patients with chronic mild hepatitis increased only slightly; in patients with moderate and severe chronic hepatitis,four liver fiber items had higher sensitivity,HA had higher sensitivity,which was the most sensitive diagnostic marker for liver fibrosis.Conclusion According to the combined detection of four items of liver fibrosis and serum GGT and PT,the results can be used as a conventional index for judging liver fibrosis of patients with chronic liver disease,providing basis for clinical drug resistance to the treatment of liver fibrosis.