血清PCⅢ水平与肝纤维化活跃程度的相关性  

The Relationship between Serum Level of PCⅢ and the Liver Fibrosis Activity

作　　者：王辉[1] 惠小阳[1] 李闻捷[1] 许育[1] 范华杰[1] 杜大海[1] 

机构地区：[1]第二军医大学长海医院实验诊断科,上海200433

出　　处：《现代检验医学杂志》2006年第5期68-70,共3页Journal of Modern Laboratory Medicine

摘　　要：目的探讨血清Ⅲ型前胶原(PCⅢ)水平与肝纤维化活跃程度的相关性及对肝细胞损伤程度的分级预示作用。方法分别用放射免疫法(R IA)及自动生化仪化学法测定70例正常对照(仅测定了PCⅢ水平)、35例原发性肝癌、44例慢性中度乙肝、37例肝硬化及26例慢性重度乙肝患者血清中Ⅲ型前胶原(PCⅢ)和其它常规肝功能项目(总胆红素、直接胆红素、总蛋白、清蛋白)水平及四种肝功能相关酶(ALT、A ST、-γGT、AKP)活性,分析不同组血清PCⅢ水平与肝纤维化活跃程度的关系及其它测定指标的相关性。结果①血清PCⅢ(μg/L)水平依次为:慢性重度乙肝患者(n=26,446.29±250.81)>肝硬化(n=37,231.87±140.94)>慢性中度乙肝患者(n=44,225.07±150.31)>原发性肝癌(n=35,216.25±134.75)>正常对照(n=70,122.56±92.94);②慢性重度乙肝组血清PCⅢ水平与总胆红素及直接胆红素呈显著正相关(均P<0.01);③肝硬化组未查见PCⅢ水平与其它指标的相关性;④慢性中度乙肝组血清PCⅢ水平与清蛋白(ALB)水平呈负相关、与A ST活性呈正相关(均P<0.05);⑤原发性肝癌组血清PCⅢ水平与总胆红素(TB il)、直接胆红素(DB il)水平及A ST、AKP活性均呈显著正相关,与清蛋白水平呈显著负相关(均P<0.01)。结论①血清PCⅢ水平可以反映肝纤维化的活跃程度,有助于肝细胞损伤程度的血清学分级;②慢性重度乙肝组较之陈旧性肝纤维化的肝硬化患者,PCⅢ代谢更为活跃,肝纤维化演变更为敏感。Objective To discuss the relationship between serum level of procollagen Ⅲ and the fibrosis activity of the liver and the damage of the liver. Methods 142 patients and 70 healthy control were studied ,the patients including 35 primary liver cancer,44 moderate chronic hepatitis B,37 liver sclerosis,and 26 severe chronic hepatitis B. The serum level of PC Ⅲ was analysed by radioimmunoassay. Serum level of total bilirubin,direct bilirubin, total protein ,albumin,ALT,AST, γ-GT and AKP were detected routingly by the autobiochemical analyzer. Results ①The serum level of PC Ⅲ in these groups were：severe chronic hepatitis B（n=26,446.29±250. 81）〉liver sclerosis （n=37,231.87±140. 94）〉moderate chronic hepatitis B（n=44,225.07±150. 31）〉primary liver cancer（n=35,216.25±134.75）〉healthy control （n=70,122. 56±92.94）.②The serum level of PC Ⅲ were positively correlated with the serum level of total bilirubin and direct bilirubin in severe chronic hepatitis B. ③There was no relationship between PC Ⅲ and the other markers in patients with liver sclerosis. ④The serum level of PC Ⅲ were negatively correlated with the serum level of albumin,and positively correlated with the serum level of AST in moderate chronic hepatitis B. ⑤PC Ⅲ were positively correlated with total bilirubin ,direct bilirubin,AST and AKP,and negatively correlated with albumin in primary liver cancer. Conclusion ①The serum level of PC Ⅲ can reflect the fibrosis activity of the liver,and are a helpful index of the degree of the liver damage. ②The anabolism of the PC Ⅲ in severe chronic hepatitis B is more active than in liver sclerosis,which is vulnerable to fibrosis.

关 键 词：血清Ⅲ型前胶原 肝纤维化 相关性 

分 类 号：R575.2[医药卫生—消化系统] R446.112[医药卫生—内科学]