肝脏超声微泡造影及肝纤维化血清学指标与慢性肝炎肝纤维化相关性的研究  

Study of the correlation between chronic hepatitis with fibrosis, and serum fibrotic markers in sera and microbubble-enhanced ultrasound imaging

作　　者：陈杰[1] 黄云丽[1] 郑颖[1] 马丽娜[1] 黄燕翔[1] 马冰[1] 陈新月[1] 孟繁坤[1] 

机构地区：[1]首都医科大学附属北京佑安医院,100054

出　　处：《肝脏》2006年第6期381-383,共3页Chinese Hepatology

基　　金：北京市科委病毒性肝炎重大项目资助(课题号:H02092000690)

摘　　要：目的研究肝脏超声微泡造影、肝纤维化血清学指标与慢性肝炎肝穿刺病理纤维化的相关性。方法选择慢性乙型肝炎患者40例（均有肝穿刺病理检查证实），酶联免疫法检测慢性乙型肝炎患者组及10例健康对照组的透明质酸、层粘素、Ⅲ型前胶原肽和Ⅳ型胶原水平；采用团注法测定肝静脉通过时间（HVTT）。结果肝纤维化血清学指标随肝穿刺病理纤维程度的升高而升高，但仅在S4期组与各组间差异有显著性；HVTT随肝穿刺病理纤维程度的升高而缩短，在S2-3及S4组分别与各组间差异有显著性。结论肝纤维化血清学指标对肝硬化（S4期）的诊断有意义，但对S3期以前的肝纤维化反应不灵敏。HVTT能反映s2到S4期的肝纤维化，因此HVTT是诊断肝纤维化的较好指标。Objective To study the correlation between serum fibrotic markers, microbubble-enhanced ultrasound imaging and histological fibrosis stage of chronic hepatitis. Methods Fourty patients with chronic hepatitis B proved by histology and 10 healthy controls were studied. The serum levels of LN,HA,IV-C,PⅢ P were determined by ELISA. Microbubble were given by bolus injection intravenously and the hepatic vein transit time（HVTr） was measured by ultrasoundgrapby. Result Serum fibrotic levels of markers increased with patients＇ liver fibrotic stages. Only between S4 group and other stage groups showed the significant difference. HVTrs decrease along with the patients＇ liver fibrotic stages. The difference is significant not only between S2-3 group and other stages groups but also between S4 group and other groups. Conclusion Liver fihrosis markers are valuable for diagnosis of liver cirrhosis. But they can not reflect the liver fibrosis lower than S3. Liver fibrosis from S2 to S4 could be diagnosed by HVTr. HVTr could be a good important reference parameter for diagnosis of liver fribrosis.

关 键 词：超声微泡造影 慢性乙型肝炎 肝穿刺组织学检查 纤维化血清学指标 

分 类 号：R575.2[医药卫生—消化系统] R575.1[医药卫生—内科学]