肝病患者血清CPⅢ、HA、LN和PLD水平的变化及其与肝纤维化的关系  

CHANGES OF SERUM CPⅢ、HA、LN AND PLD CONCENTRATIONS AND THEIR RELATIONSHIP WITH SEVERITY OF HEPATOFIBROSIS IN PATIENTS WITH HEPATITIS

作　　者：周莉[1] 熊鹰[1] 阎德文[1] 李卓成[2] 陈剑雄[2] 吴万生[2] 罗天勇[3] 

机构地区：[1]深圳市红十字会医院内科,518029 [2]深圳市红十字会医院检验科,518029 [3]贵阳医学院附属医院传染科

出　　处：《放射免疫学杂志》1998年第2期69-71,共3页Journal of Radioimmanology

摘　　要：为了探讨血清Ⅲ型前胶原(PCⅢ)、脯氨酸肽酶(PLD)、透明质酸(HA)和层粘连蛋白(LN)对肝纤维化的的诊断价值,本文对103例会上肝病患者血清中的这些指标的代谢变化进行了观察,并对其中23例肝活检患者中这些指标与肝纤维化程度之间的相关性进行了分析。结果发现,与正常人相比,慢活肝(CAH)和肝硬化(LC)患者血清PCⅢ,LN、HA和PLD水平明显增高(p<0.01),而慢迁肝(CPH)和急性肝炎(AH)患者上述各项指标的变化与正常人比较差异并不明显(p>0.05)。血清PCⅢ、LN、HA和PLD的异常高值趋向性地向LC和CAH集中,其升高的方向及程度与肝损病和肝纤维化发展的的方向程度保持良好的一致性。相关分析亦发现肝活检患者肝纤维化程度与其血清PCⅢ、LN、HA和PLD水平的变化呈显著正相关(n=23,r=+0.64+0,89,p<0.01)。提示血清PCⅢ、LN、HA和PLD等指标均能较好地反映肝病的慢性化程度和肝纤维化的活动水平及程度,且较少受肝细胞损伤性因素的影响。在反应肝纤维化程度方面,HA和LN似更优于PCⅢ和PLd。To investigate the changes of serum precoilagen tyte Ⅲ(PC Ⅲ), prolidase (PLD), hyaluronic acid(HA) and laminin (LN) and their relation ship with severity of hepatofibrosis in patients with hepatitis, serum levels of those parameters were measured in 103 patients with HBV infection and 39 healthy subjects. Liver biopsies were obtained in 23 patients (CAH8, LC15) and the relationship between levels of these 4 serum components and severity of liver fibrosis was studied. The results showed: (1) serum levels of CPⅢ, HA,LN and PLD were significantly elevated in patents with CAH and LC(p<0.01); but not in patients with acute hepatitis (AH) and chronic persistent hepatitis (CPH) (p>0.05); (2) Patients with CAH and LC had significantly higher serum concentrations of CPⅢ,HA, LN and PLD than those in patients with AH and CPH Abnormal high values of the four parameters were distributed concentratedly in the CAH and LC groups (p<0.01); (3) Serum levels of CPⅢ, HA, LN and PLD were all positively correlated with Severity of liver fibrosis in biopsy specimens from the 23 patients studied (r= +0.64- + 0.89, p<0.01). These findings suggested that these 4 serum components might reflect the chronicity of the hepatitis and the degree of hepatofibrosis and were less related to hepato-cellular damage.HA and LN changes seemed to be more sensitive.

关 键 词：Ⅲ型前胶原 脯氨酸肽酶 肝脏疾病 肝纤维化 

分 类 号：R575[医药卫生—消化系统]