慢性肝炎患者血清透明质酸单项升高的临床意义  

Clinical significance of single increase of serum hyaluronic acid in serum fibrosis indicators in patients with chronic hepatitis

作　　者：张继万[1] 王海滨[2] 张晓芳[1] 隆莉[1] 王滨容[1] 罗丽莎[1] 邝敏[1] 

机构地区：[1]武警四川总队医院,乐山614000 [2]解放军第三○二医院,北京100039

出　　处：《传染病信息》2008年第4期233-234,共2页Infectious Disease Information

摘　　要：目的研究慢性肝炎患者肝纤维化四项中血清透明质酸(HA)单项升高的临床意义。方法对解放军第三○二医院2006年8月—2007年4月临床检测的肝纤维化四项单项 HA 升高的713例患者的血清总胆红素(TBIL)、胆碱酯酶(CHE)及 HBVDNA 定量等指标,按 HA 升高程度进行分组分析,同时动态观察 HA 变化与肝功能之间的关系。结果在被检测的3 889例慢性肝炎患者中,单项 HA 升高者713例(18.3%)。随着血清中 HA 水平升高,患者血清胆红素呈相应升高趋势。HA>500mg/ml 组的 TBIL 显著高于 HA<500mg/ml 组(P<0.01),CHE 则随 HA 的升高相应呈下降趋势;HA>1 000mg/ml 组的患者,CHE 下降显著(P<0.001),但 HA 的变化与血清 HBV DNA 含量的变化无明显关系(P>0.05)。动态研究表明,随单项HA 含量的下降,慢性肝炎患者的血清 TBIL 亦显著下降,CHE 明显回升。结论血清单项 HA 水平升高与肝脏功能损伤程度关系密切,可作为动态观测肝脏功能变化的指标之一。Objective To investigate the clinical significance of single increase of serum hyaluronic acid （HA） in four serum fibrosis indicators in patients with chronic hepatitis. Methods A total of 713 cases with increasing HA only in four fibrosis indicators detected in 302 hospital of PLA during Aug. 2006 and Apr. 2007 were investigated in this study. All the 713 patients were divided into different groups according to the increasing levels of HA, and the relationship between HA changes and liver function was observed dynamically as well. Results Of 3 889 patients with chronic hepatitis, 713 （18.3%） were detected to have a single increase of serum HA in four serum fibrosis indicators. There was a positive correlation between the increasing HA and the changes of TBIL. TBIL of the patients with HA more than 500 mg/ml was higher dramatically than that of patients with HA less than 500 mg/ml （P〈0.001）, while CEH decreased with HA increasing. In patients with HA more than 1 000 mg/ml, CEH decreased dramatically, but HA changes weren＇t correlated to serum HBV DNA （ P〉0.05 ）. It was shown that with HA decreasing, serum TBIL decreased and CEH increased significantly. Conclusion There is a close correlation between the single increase of HA in four serum fibrosis indicators and liver injury, and it can be an indicator of observing the damaged degree of liver function.

关 键 词：慢性肝炎 透明质酸 总胆红素 胆碱酯酶 

分 类 号：R512.6[医药卫生—内科学]