重型肝炎患者血清肝纤维化指标及甲胎蛋白水平的动态变化及其与预后的关系  

Dynamic changes of serum fibrosis indices and alpha fetoprotein and their relations with prognosis of patients with severe hepatitis

作　　者：时红波[1] 陈煜[2] 韩大康[2] 赵军[2] 武志明[1] 段钟平[2] 

机构地区：[1]北京市卫生局肝炎研究所,北京市100069 [2]首都医科大学附属北京佑安医院人工肝中心,北京市100069

出　　处：《世界华人消化杂志》2008年第21期2408-2411,共4页World Chinese Journal of Digestology

基　　金：国家重点基础研究发展计划(973)资助项目;No.2007CB512801;中国肝炎防治基金会王宝恩肝纤维化研究基金资助项目;No.20070025~~

摘　　要：目的:初步探讨重型肝炎患者血清肝纤维化指标及甲胎蛋白(AFP)水平的动态变化及其与预后的关系.方法:在比较89例病毒性肝炎患者血清肝纤维化指标及AFP水平的基础上,着重研究其中39例重型肝炎患者血清肝纤维化指标及AFP水平在不同时期的动态变化规律.结果:重型肝炎患者血清透明质酸(HA)、Ⅲ型胶原氨基末端肽(PⅢP)和AFP水平高于慢性肝炎患者及正常人(3273.19±2060.83vs127.63±110.63,35.50±18.59;2.13±1.20vs1.18±0.43,0.80±0.18;130.98±244.51vs20.40±12.68,7.50±1.23,均P<0.05),重型肝炎患者血清LN水平仅高于正常人(148.95±54.47vs120.70±18.35,P<0.05);HA、PⅢP和LN在生存组总体呈现下降趋势,死亡组呈现上升趋势,AFP水平在生存组呈现先升后降趋势,在死亡组急剧下降;血清HA、PⅢP、LN和AFP水平在亚急性组低于慢性组;重型肝炎患者HA与PTA、ALB、TBIL有较好的相关性(r=-0.372,-0.395,0.344,均P<0.05).结论:动态监测血清HA、PⅢP、LN和AFP水平对重型肝炎患者的预后判断有一定意义.AIM： To explore the correlation between dynamic changes of serum fibrosis indices and alpha fetoprotein （AFP） and the prognosis of patients with severe hepatitis （SH）. METHODS： Based on the comparison of serum fibrosis indices and alpha fetoprotein in 89 patients with viral hepatitis, their dynamic changes in different periods were studied dominatingly in 39 SH patients. RESULTS： The levels of HA, PIIIP and AFP in SH patients were higher than those in chronic hepatitis （CH） patients and normal individuals （3273.19 ± 2060.83 vs 127.63 ± 110.63, 35.50 ± 18.59; 2.13± 1.20 vs 1.18 ± 0.43, 0.80± 0.18; 130.98 ± 244.51 vs 20.40 ± 12.68, 7.50 ± 1.23; all P 〈 0,05）. The level of LN in SH patients was higher than that in nomal individuals （148.95±54.47 vs 120.70 ± 18.35, P 〈 0.05）. The levels of HA, PIIIP and LN tended to decrease in the living patients and to increase in the dead patients. The AFP level was elevated first and then reduced in the living patients, but showed a marked decreased trend in the dead patients. The serum levels of HA, PIIIP, LN and AFP in the subacute group were lower than those in the chronic group. In SH patients, HA level was significantly correlated with PTA, ALB and TBIL levels （r -- -0.372, -0.395, 0.344, respectively; all P 〈 0.05）. CONCLUSION： It is definitely valuable to dynamically inspect serum HA, PIIIP, LN and AFP level for the prognosis of SH patients.

关 键 词：重型肝炎 肝纤维化指标 甲胎蛋白 动态变化 

分 类 号：R575.1[医药卫生—消化系统]