联合检测多种细胞外基质因子对肝纤维化的诊断

THE STUDY OF THE COMBINATION DETECTION SOME EXTRA CE LLULAT MATRIXES IN THE DIAGNOSIS OF LIVER FIBROSIS

目的 创建出一套无创、简便易行的诊断肝纤维化的方法。方法 以肝活检为肝纤维化诊断的金标准 ,同时检测肝纤维化和正常对照者血清中的透明质酸、层粘连蛋白、纤粘连蛋白、血清IV型胶原、血清III型前胶原氨基端肽和血清脯氨酸肽酶 (以下分别简称HA、LN、FN、IV -C、PⅢP和PLD) ,并采用多元Logistic回归分析建立诊断方程。 结果 肝硬化组和慢性乙型肝炎 (重度 )以上各指标差别均无显著性意义 ,慢性乙型肝炎 (重度 ) >慢性乙型肝炎 (中度、轻度 ) >正常对照。HA、、LN、PⅢP、IV -C、PLD各因素均进入回归方程。以回归方程预测的肝纤维化T值大于 0 95者做判断肝纤维化的标准 ,结果该法诊断的灵敏度和特异度分别为 86 7%和 80 0 % ,符合率为 85 %。结论 肝细胞基质HA、LN、PⅢP、IV -C、PLD是肝纤维化的诊断的敏感指标 。

Objective Objective To build formula of mod el in the diagnosis of liver fibrosi s by combination detection some extra cellular matrixes Methods Liver biopsy we re used to gold standard of diagnosis liver fibrosis, serum fibrosis markers of liver fibrosis group and normal control group were detected There are differen tiate parameters between two groups in single factors analysis were used to for evaluated by logistic regression analysis, and building logistic regression equa tion Results There was no difference between liver cirrhosis and sev ere chronic B liver disease(P<0 05),but there was a significant difference amon g severe and middle chronic B liver disease and normal control The regression equation of some parameters was established, the sensitive and specification of regression evaluation diagnosis liver fibrosis were 86 7% and 80 0% respectiv ely Conclusion The combination of noninvasive parameters is more va luable than single parameter in the diagnosis of liver fibrosis, and having buil d regression evaluation by detect extra cellular matrixes can be progress liver fibrosis