血清补体C3和C4对慢性乙型肝炎患者肝组织病理状态的判断价值  

Serum complement C3 and C4 levels for evaluation of hepatic pathological status in patients with chronic hepatitis B

作　　者：张占卿[1] 陆伟[1] 王雁冰[1] 饶敏[1] 冯洁[1] 沈芳[2] 冯艳玲[3] 

机构地区：[1]上海市公共卫生临床中心肝病二科,上海市201508 [2]上海市公共卫生临床中心检验科,上海市201508 [3]上海市公共卫生临床中心病理科,上海市201508

出　　处：《世界华人消化杂志》2011年第17期1791-1795,共5页World Chinese Journal of Digestology

基　　金：国家863计划生物和医药技术领域重大/重点基金资助项目;No.2006AA02A411;上海市科委科技计划基金资助项目;No.09411965800~~

摘　　要：目的:探讨血清补体C3和C4判别慢性乙型肝炎患者肝组织病理学分级和分期的价值.方法:456例经肝组织病理学检查的慢性乙型肝炎患者入选本研究.血清补体C3和C4采用Beckman-Coulter Immage 800免疫化学系统及其配套试剂测定.血清补体C3和C4判别病理学分级和分期的评价采用Bayes逐步判别分析.结果:符合模型纳入变量、进入判别不同病理学分级和分期的Fisher's判别函数的指标分别只有补体C3和C4(Wilks'λ=0.967,χ2=15.312,P=0.002;Wilks'λ=0.938,χ2=28.724,P=0.000).基于补体C3的判别函数判别病理学分级G1、G2、G3、G4和基于补体C4的判别函数判别病理学分期S0、S1、S2、S3、S4的符合率分别为46.34%、6.28%、20.61%、72.73%和6.90%、46.51%、7.58%、8.91%、61.11%.根据判别函数,当患者补体C3≥0.84g/L和≤0.65g/L时,其肝组织病理学分级=G1和G4的可能性较大;当患者补体C4≥0.18g/L和≤0.14g/L时,其肝组织病理学分期=S1和S4的可能性较大.结论:血清补体C3和C4分别对慢性乙型肝炎患者肝组织病理学分级和分期有一定判别意义.AIM： To explore the possibility of using serum complement C3 and C4 levels to estimate the hepatic pathological status in patients with chronic hepatitis B. METHODS： Four hundred and fifty-six patients with pathologically proven chronic hepatitis B were enrolled in present study. Serum complement C3 and C4 levels were determined using the Beckman-Coulter Immage 800 immunochemistry system and auxiliary reagents （Beckman-Coulter Inc., USA）. Bayes stepwise discriminant analysis was used for evaluation of serum complement C3 and C4 in discriminating hepatic pathological grade and stage. RESULTS： Only serum C3 or C4 entered the Fisher’s discriminant functions for discriminating hepatic pathological grade and stage according to the entry criteria of the independents （Wilks＇ λ = 0.967, χ2 = 15.312, P = 0.002 and Wilks＇ λ = 0.938, χ2 = 28.724, P = 0.000）. The correctly classified rates of the originally grouped cases by the discriminant functions built with serum complement C3 and C4 were 46.34% for G1, 6.28% for G2, 20.61% for G3, 72.73% for G4 and 6.90% for S0, 46.51% for S1, 7.58% for S2, 8.91% for S3, 61.11% for S4, respectively. According to the discriminant functions for discriminating different pathological grades and stages, patients had a higher probability of G1 and G4 when serum complement C3 level was no less than 0.84 g/L and no more than 0.65 g/L, respectively, and of S1 and S4 when serum complement C4 level was no less than 0.18 g/L and no more than 0.14 g/L respectively. CONCLUSION： Serum complement C3 and C4 levels have appreciable significance in discriminating hepatic pathological grade and stage in patients with chronic hepatitis B.

关 键 词：补体 乙型肝炎 病理学 无创诊断 

分 类 号：R512.62[医药卫生—内科学]