肝硬化合并肝癌血氨水平、层粘连蛋白、Ⅳ型胶原变化与Child-Pugh分级间的相互关系  

The relationship between the level of plasma ammonia and the changes of serum laminin and type Ⅳ collagen in patients with liver cirrhosis and hepatocellular carcinoma in reference to Child-Pugh scores

作　　者：叶迎宾 郭卫刚[1] 柴广丽[1] 章健[1] 田楠楠[1] 王晓芳[1] 黄秀香[1] 李友生[1] 

机构地区：[1]河北邯郸市传染病医院检验科,河北邯郸056002

出　　处：《国际检验医学杂志》2013年第18期2394-2395,2397,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨肝硬化合并肝癌患者血氨水平、层粘连蛋白和Ⅳ型胶原水平变化与肝功能Child-Pugh分级间的关系。方法选取108例肝硬化合并肝癌患者（肝癌组）,其中男71例,女37例;年龄37~71岁,平均55.6岁。按照Child-Pugh分级标准,A级28例,B级32例,C级48例。对照组67例,男41例,女26例;年龄37~62岁,平均46.8岁。采用化学发光法检测层粘连蛋白（LN）、Ⅳ型胶原（Ⅳ-C）,血氨（NH3）采用连续监测法。比较肝癌组与对照组、肝癌组Child-Pugh分级间的NH3水平、层粘连蛋白（LN）、Ⅳ型胶原（Ⅳ-C）的变化。结果与对照组相比,肝癌患者NH3、LN、Ⅳ-C均升高,差异有统计学意义（P〈0.05）。随着Child-Pugh等级上升,NH3、LN、Ⅳ-C逐渐升高差异有统计学意义（P〈0.05）。肝癌患者随着肝功能的下降,NH3与LN呈显著正相关（r=0.556 2、0.690 0、0.342 3,P〈0.05）,与Ⅳ-C无显著相关。结论血氨和层粘连蛋白有显著相关性,对肝硬化合并肝癌无创伤诊断有一定的临床意义。Objective To explore the relationship between the level of plasma ammonia and the change of serum laminin and typeⅣcollagen in patients with liver cirrhosis and hepatocellular carcinoma with different degrees of their liver lesions.Methods A total of 108patients with hepatic cirrhosis and liver cancer（liver cancer group）were enrolled,male 71,female 37,age 37-71 years old,mean age 55.6years old.They were divided into three subgroups（A,B,and C）on the basis of Child-Pugh classfication.Among the patients,28were classified as Child-Pugh class A,32were class B,48were class C.67healthy individuals served as controls,male 41,female 26,age 37-62years old,mean age 46.8years old.Serum laminin（LN）,typeⅣ collagen（Ⅳ-C）were determined by chemiluminescence and plasma ammonia（NH3）was determined by continuous monitoring method.Compared with the results in liver cancer group and control group,Child-Pugh classification the level of NH3,LN,Ⅳ-C in liver cancer group.Results Compared with the control group,NH3,LN,andⅣ-C were increased in patients with cancer of the liver,there were significant difference between the two groups（P〈0.05）.NH3,HA,LN,PCⅢ and Ⅳ-C increased,with the increase of the Child-Pugh grades,there were significant difference between the three groups（P〈0.05）.NH3and LN was positively correlated with the decline in liver function（r=0.556 2、0.690 0、0.342 3,P〈0.05）,NH3was no significant correlation with Ⅳ-C.Conclusion The certain clinical significance of non-invasive diagnosis between the level of NH3and LN in patients with liver cirrhosis and hepatocellular carcinoma,because of the positive correlation to them.

关 键 词：氨 层粘连蛋白 胶原 肝硬化 肝肿瘤 

分 类 号：R575.2[医药卫生—消化系统]