肝病患者血清PCⅢ、HA、LN和PLD水平的变化及其与肝纤维化的关系  

Changes of Serum PCⅢ, HA, LN and PLD Concentrations and Their Relationship with Hepatofibrosis in Hepatitis

作　　者：周莉[1] 李卓成[2] 陈剑雄[2] 罗天勇 

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

出　　处：《标记免疫分析与临床》1998年第4期186-190,共5页Labeled Immunoassays and Clinical Medicine

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）对肝纤维化的诊断价值，本文对103例肝病患者血清中的这几个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、CN、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害和肝纤维化发展的方向及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。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影响。在反映肝纤维化程度方面，HA和LN似更优于PCⅢ和PLD。To investigate the changes of serum precollagen type Ⅲ(PCⅢ), prolidase(PLD),hyaluronic acid(HA)and laminin(LN)and their relation with hepatofibrosis in patients with hepatitis, serum levels of PCⅢ, HA, LN and PLD were measured in 103 patients with HBV infectionand 39 healthy subjects. The liver biopsies were carried out and the relationship between these 4serum components and liver histological fibrosis were studied in 23 patients with chronic activehepatitis (CAH)and liver cirrhosis(LC). The results showed: (1) As compared with healthy sub-sub-jects, serum levels of PCⅢ,HA, LA and PLD were significantly elevated in patients with CAHand LC(P < 0.01 ); (2)There was no difference in seum levels of these 4 fibrosis markers betweenhealthy subjects and patients with acute hepatitis(AH)and chronic persistent hepatitis(CPH)(P>0.05); (3)Patients with CAH and LC had significantly higher serum concentrations of PC-Ⅲ,HA, LN and PLD than those with AH and CPH(P < 0.01); (4) Serum levels of PCⅢ,HA, LNand PLD were all positively correlated with liver fibrosis in 23 patients with CAH and LC diag-nosed by biopsy (r = + 0. 64 ～ + 0.89, P < 0.01). These findings suggest that these 4 serumcomponents may reflect the degree of hepatofibrosis and severity of liver damage and that the de-tection of serum levels of these 4 fibrosis markers is important for clinical diagnosis of hepatic fi-fibrosis in patients with hepatitis.

关 键 词：Ⅲ型前胶原 脯氨酸肽酶 透明质酸 肝纤维化 诊断 

分 类 号：R575.204[医药卫生—消化系统] R575.06[医药卫生—内科学]