HA、LN、CⅣ、PCⅢ联合检测在肝纤维化中的诊断意义  

The diagnostic significance of co-detection of serum HA、LN、CⅣ and PCⅢ in the liver fibrosis

作　　者：张一[1] 余叔侃[1] 刘寄尘[1] 黄建生[1] 易冬英[1] 

机构地区：[1]江西医学院第一附属医院,南昌330006

出　　处：《江西医学检验》2000年第1期1-3,共3页Jiangxi Journal of Medical Laboratory Sciences

摘　　要：目的　寻找诊断肝纤维化的敏感可靠之血清指标。方法　用放免法对 34 1例住院肝炎患者联合检测血清透明质酸 (HA)、层粘连蛋白 (LN)、IV型胶原 (IV)、Ⅲ型前胶原 (PCⅢ ) ,同时进行肝炎病毒标志物 ,B型超声波相关指标检测 ,进行对比研究。结果　四项指标分别在急性和慢性肝炎轻型、慢性中型、亚急性重型肝炎、慢性重型肝炎中依次升高 ,差异有显著性 (P <0 .0 5 ) ,肝硬化组升高略低于亚急性重型组。而肝炎病毒标志物分组检测四项指标差异无显著性。B超检查提示门静脉高压的肝硬化组四项指标检测与无门脉高压组比较差异显著 (P <0 .0 5 )。结论　四项指标联合检测对肝纤维化的临床诊断提供了准确可靠的指标。动态观察其变化可掌握病情的演变情况 ,并可作为临床抗肝纤维化药物治疗疗效判断的可靠指标。Objective To explore a sensitire and reliable serological index for the diagnosis of liver fibrosis.Method Hyaluronic acid (HA)、laminin(LN)、type Ⅳ collagen(Ⅳ) and type Ⅲ procollagen(PCⅢ) were determined in 341 patients with hepatitis B by radioimmunoassay. Hepatitis B virus markers were detected in this group as well. A part of them were examined by B ultrasonography for comparison. Results Four serological indices elevated in acute mild, and chronic mild hepatitis, chronic moderate hepatitis, Subacute hepatitis gravis and chronic hepatitis gravis successively, showing significant differences (P<0.05). The degree of elevation in the group of hepatic cirrhosis was slightly lower than that in the group of subacute hepatitis gravis. Determination of the four indices in groups according to hepatitis B virus markers showed no significant difference (P<0.05). Determination of the four indices in the group of hepatic cirrhosis with portal hypertension was significantly different from those without portal hypertension suggested by B ultrasonography. Conclusion co-detection of four serlolgical indices provides an accurate and reliable index for the clinical diagnosis of liver fibrosis. Dynamic observation of their changes may master the progress of disease and be used as a reliable index to judge the therapeutic effect of antifibrotic drugs of the liver clinically.

关 键 词：肝纤维化 透明质酸 层粘连蛋白 IV型胶原 PCⅢ 

分 类 号：R575.204[医药卫生—消化系统] R446.112[医药卫生—内科学]