慢性乙肝血清肝纤维化标志物检测临床意义  

Clinical significance of detection of serum markers of liver fibrosis in patients with chronic hepatitis B

作　　者：彭景[1] 张绪清[1] 王贵波[1] 毛青[1] 

机构地区：[1]第三军医大学西南医院全军感染病研究所,重庆400038

出　　处：《西南国防医药》2009年第6期578-580,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的:评价血清肝纤维化标志物(透明质酸、Ⅲ型前胶原、Ⅳ型胶原、层粘蛋白)在诊断慢性乙型病毒性肝炎(乙肝)患者肝纤维化程度中的价值。方法:应用放射免疫法检测111例慢性乙肝患者血清肝纤维化标志物:透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)和层粘蛋白(LN);采取肝穿刺活检对肝组织进行病理诊断,判断肝组织纤维化程度,分析HA、PCⅢ、CⅣ和LN变化与患者病情及肝脏病变程度的关系。结果:HA、PCⅢ和CⅣ异常率随肝炎发病程度及肝组织纤维化程度加重而显著升高,呈显著正相关;LN异常率与肝炎发病程度及肝组织纤维化程度无显著关系。双向有序列连表统计提示,血清肝纤维化标志物联合检测在肝组织纤维化程度判断中具有显著意义(χ2=14.277,P=0.002),血清肝纤维化标志物联合检测异常数量与肝组织纤维化程度为正相关(r=0.499,P=0.001)。结论:血清HA、PCⅢ、CⅣ联合检测可用于肝组织纤维化程度的判断。Objective： To evaluate the value of serum markers （ hyaluronic acid, type Ⅲ procollagen, type Ⅳ collagen, laminin） in diagnosis of liver fibrosis in patients with chronic hepatitis B. Methods： Radioimmunoassay method was used to determine the fibrosis markers in 111 cases of chronic hepatitis B： hyaluronic acid （HA）, type Ⅲ procollagen （PC Ⅲ）, type 1V collagen （C Ⅳ ） and laminin （LN）. Liver biopsy was used in the pathological diagnosis of liver tissue to determine the degree of liver fibrosis. The relationships between HA, PC Ⅲ, c Ⅳ, LN changes and the severity of pathogenetic condition as well as the degree of liver fibrosis were analyzed. Results： Abnormal rate of HA, PC Ⅲand C Ⅳ significantly increased along with the degree of hepatitis B and liver fibrosis, and they were positively correlated. Abnormal rate of LN had no significant correlation with the degree of hepatitis B and liver fibrosis. Bi - directional sequence table statistics indicated that combined detection of serum fibrosis markers had statistical significance in the determination of the degree of liver fibrosis （χ2 = 14. 277,P = 0. 002 ）, and the abnormal number of the serum fibrosis markers by combined detection had positive correlation with the degree of liver fibrosis （ r =0. 499 ,P =0. 001 ）. Conclusion ： Combined detection of serum HA, PCⅢ and C Ⅳcan be used to determine the degree of liver fibrosis.

关 键 词：慢性乙型肝炎 肝纤维化 诊断 血清学 

分 类 号：R446.11[医药卫生—诊断学]