慢性乙型肝炎患者中医证型与肝组织病理、肝内Ⅳ型胶原免疫组化及血清肝纤维化指标的关系  

Clinical Evaluation of Liver Histopathology and C Ⅳ Immunohistochemistry of Interhepatic and PC Ⅲ、HA、C Ⅳ Examination in the Serum with TCM Type of Syndromes in the Patients with Chronic Hepatitis B

作　　者：肖和杰[1] 李从荣[1] 罗光义[1] 任剑霞[1] 李平[1] 张佳光[1] 石次国[1] 姚亮[1] 杨枳春[1] 王永华[1] 

机构地区：[1]三峡大学第三临床学院肝脏病中心,湖北宜昌443002

出　　处：《中西医结合肝病杂志》2005年第6期334-336,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探讨慢性乙型肝炎(CHB)患者中医证型与肝组织病理、肝内Ⅳ型胶原(CⅣ)及血清Ⅲ型前胶原(PCⅢ)、透明质酸(HA)、CⅣ同步检测的相关性及对肝纤维化的诊断意义。方法:104例CHB患者进行中医辨证分型、肝组织病理学、肝内CⅣ免疫组化及血清PCⅢ、HA、CⅣ的检测。结果:①病理学诊断属CHB轻度者74例,中度21例,重度9例;②中医辨证分型:属肝郁脾虚型56例(53.88%)、肝胆湿热型3例(2.85%)、肝肾阴虚型14例(13.46%)、脾肾阳虚型5例(4.81%)及瘀血阻络型26例(25.00%);③CHB轻度组,中医辨证以肝郁脾虚型为主,占71.62%(53/74);中度组以瘀血阻络型为主,占66.66%(14/21);重度组病例均属瘀血阻络型。④依中医证型肝内CⅣ免疫组化检测,瘀血阻络型肝内CⅣ检测值显著高于其他各型(P<0.01);⑤血清PCⅢ、HA与CⅣ检测值瘀血阻络型均显著高于其他各型(P<0.01);⑥肝内CⅣ检测值与血清PCⅢ、HA和CⅣ检测值比较,呈明显正相关性(r值分别为0.995,0.993,0.984;均P<0.01)。结论:CHB患者肝组织病理、肝内CⅣ免疫组化及血清PCⅢ、HA、CⅣ同步检测与中医证型间有显著相关性,对指导CHB患者肝纤维化的诊断与治疗具有重要临床意义。Objective： To research the relationship between hepatic pathological diagnosis and quantity of CⅣ in liver tissue, PCⅢ, HA and CⅣ examination in the serum and traditional Chinese medicine （TCM） type of syndromes in the patients with chronic hepatitis B. Methods： Serum levels of PCⅢ, HA, and CⅣ and liver tissue pathological dignosis and the CⅣ immunohistochemistry of interheptic and TCM type of syndromes in 104 patients with chronic hepatitis B were investigated. Results： ①There were the low grade 74, moderate 21 and the severe 9 patients in the hepatic histopathological findings. ②TCM differentiation of symptoms and signs： stagnation of the liver Qi and deficiency of the spleen was 56, damp-heat of liver and gall 3, deficiency of liver-Yin and kidney-Yin 14, insufficiency of both the spleen-Yang and the kidney-Yang 5, blood stasis vessel obstruction syndrome 26 patients. ③Stagnation of the liver Qi and deficiency of the spleen was 71.62% （53/74） among lowgrade chronic hepatitis B, blood stasis vessel obstruction syndrome was 66.66% among moderate chronic hepatitis B, the patients were all blood stasis vessel obstruction syndromes among severe grade chronic hepatitis B and cirrhosis. OThe CⅣ immunohistochemistry quantitative of interhepatic was maximum and compared with other TCM type of syndromes among blood stasis vessel obstruction syndromes （P〈0.01） . ⑤Serum levels of PCⅢ, HA and CⅣ were maximum among blood stasis vessel obstruction syndromes and compared with other TCM type of syndromes （P 〈 0.01 ） . ⑥The CⅣ level of interhepatic with PCⅢ, HA, and CⅣ in serum were compared with that there were all well-marked relationship （ r value respectively = 0.995, 0.993, 0.984 ; P 〈 0.01 ） . Conclusion： There were all important clinical value, among pathological examination of the liver tissue, CⅣ immunohistochemistry of interhepatic, PCⅢ, HA and CⅣ levels in the serum and TCM type of syndromes.

关 键 词：中医证型 肝炎 乙型 慢性 肝/病理学 免疫组织化学 肝纤维化 

分 类 号：R259[医药卫生—中西医结合]