慢性肝炎肝纤维化血清学指标与肝组织病理变化的关系探讨  

Relationships between serum markers of liver fibrosis and pathological changes in chronic hepatitis

作　　者：谢秋里[1] 王功遂[1] 刘梅华[1] 

机构地区：[1]广东省佛山市顺德区第一人民医院感染科,528300

出　　处：《福建医药杂志》2005年第2期23-25,共3页Fujian Medical Journal

摘　　要：目的　探讨肝纤维化血清学指标与慢性肝炎肝组织炎症活动度及纤维化程度的相关性。方法　324例慢性肝炎患者经肝脏活检行常规病理检查, 同时肝活检前一周内采血检测血清纤维化指标[Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(ⅣC)、透明质酸(HA)、层粘蛋白(LN)], 探讨它们与肝脏病理的关系。结果　血清PCIII、HA、IV C水平与肝组织病理分期有相关性, PCⅢ、HA水平随纤维化分期(S1→S4) 依次升高, 各期中差异有显著性; PCⅢ水平在S0 期已有明显升高。IV C水平在肝组织病理纤维化分期各期中无差异。LN水平与肝纤维化分期无相关性。血清PCⅢ、HA、ⅣC水平与肝组织病理分级有相关性, PCⅢ、HA水平随着组织病理分级而升高,各级中差异有显著性。ⅣC水平在肝组织病理分级中有差异, 但其水平不随分级而升高。结论　血清PCIII、HA水平与肝组织病理的分级和分期的相关性较好, 是反映肝纤维化程度的良好指标, 有较高的诊断价值; ⅣC、LN水平对肝纤维化的诊断价值有待进一步研究。Objective To investigate the relationship between serum makers of liver fibrosis and liver histopathologic changes in chronic hepatitis Methods To perform liver biopsies and regular pathologic examination for 324 chronic hepatitis patients,the serum fibrosis markers[type Ⅲ procollagen PCⅢ],type Ⅳ collagen(Ⅳ C),hyaluronate acid(HA),Laminin(LN)]were measured,In order to compare levers of the markers with the histopathological grade and stage of the patients Results The serum levels of PCⅢ、HA、Ⅳ C are closely correlated with the histopathological stage( r =0 331、0 279、0 163,respectively; p <0 01);The levels of PC Ⅲ and HA obviously raise with the fibrosis staging S 1to S 4,PCⅢ raises obviously in the stage of S 0 Ⅳ C is the same in each staging LN is not correlated with the histopathological staging The levels of PCⅢ,HA,Ⅳ C are closely correlated with the histopathological grade,and PC Ⅲ and HA obviously raise with the histopathological grade changes Ⅳ C changes in the histopaathological grading,but not raising relatively with the grading Conclusion The serum PCⅢ,HA is found to be a useful markers of the liver fibrosis ,which is closely related to the histopathological grade and stage,but Ⅳ C,LN may be not PCⅢ may be a early diagnostic makers for liver fibrosis

关 键 词：肝纤维化血清学指标 组织病理变化 关系探讨 Ⅲ型前胶原(PCⅢ) 肝组织炎症活动度 血清纤维化指标 病理纤维化分期 血清PCⅢ 常规病理检查 慢性肝炎患者 病理分级 肝纤维化程度 诊断价值 相关性 肝组织病理 Ⅳ-C 肝脏活检 

分 类 号：R575.2[医药卫生—消化系统]