慢性乙型肝炎患者血清肝纤维化指标水平及检测意义  

Serum liver fibrosis levels and detection value in patients with chronic hepatitis B

作　　者：封莉[1] 吴敏娟[1] 徐俊驰[1] 王凤平[1] 陈婷婷 胥萍[1,2] FENG Li;WU Min -juan;XU Jun -chi;WANG Feng -ping;CHEN Ting -ting;XU Ping(Clinical Laboratory,the Fifth People's Hospital of Suzhou(Infectious Disease Hospital Affiliated to Suzhou University),Suzhou,Jiangsu 215007,China)

机构地区：[1]苏州市第五人民医院(苏州大学附属传染病医院)检验中心,江苏苏州215007 [2]苏州市感染免疫重点实验室,江苏苏州215007

出　　处：《中国卫生检验杂志》2019年第2期199-201,共3页Chinese Journal of Health Laboratory Technology

基　　金：国家科技支撑计划子课题项目(2015BAI32H00)

摘　　要：目的探讨血清4项肝纤维化检测指标[透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)]在慢性乙肝患者血清中的水平及检测的临床意义。方法 127例慢性乙型肝炎患者根据肝脏活检的纤维化程度分为S1～S4组,采用化学发光法检测血清HA、LN、PCⅢ、CⅣ水平,另选取健康体检者30例为正常对照组。对各组之间检测结果进行比较,并对4项指标与肝纤维化程度的相关性分析。结果 4项指标水平随肝组织纤维化程度总体呈现上升趋势,S4组的4项指标水平均显著高于S3组,差异有统计学意义(P <0. 05);肝脏组织纤维化程度分期与血清4项肝纤维化指标呈正相关性(P <0. 01);肝纤4项指标对肝脏纤维化程度≥S1的AUC分别为0. 862(HA)、0. 721(LN)、0. 858(PⅢ)、0. 814(CⅣ),灵敏度由高至低为PⅢ> HA> CⅣ> LN,特异度为HA> LN> PⅢ> CⅣ。结论活动性进展期的慢性乙型肝炎患者,肝纤4项检测结果能较好的反应肝纤维化程度,对临床的诊断,治疗效果监测及预后判断具有重要意义。Objective To investigate the detections and clinical significance of hyaluronic acid (HA),laminin (LN),type Ⅲ procollagen (PCⅢ)and type Ⅳ collagen (CⅣ)in patients with chronic hepatitis B.Methods Totally,127 cases of chronic hepatitis B were divided into S1-S4 groups,according to the degree of liver fibrosis.The levels of serum HA,LN,PGⅢ and CⅣ were detected by chemiluminescence method,and 30 normal controls were set.The test results between the groups were compared,and the correlation between the four indicators and the liver fibrosis degree was analyzed.Results The levels of four indexes showed an increasing trend with fiver tissue fibrosis.The four indexes of S4 group were significantly higher than that of S3 group,with the differences statistically significant (P<0.05).The stage of liver tissue fibrosis was positively correlated with the four liver fibrosis indexes (P <0.01 ).AUC of liver fibrosis ≥S1 for liver fibrosis were 0.862(HA),-0.721 (LN),0.858 (PⅢ),and 0.814(CⅣ),respectively.The sensitivity was PⅢ>HA >CⅣ>LN from high to low,and specificity wasa HA>LN>PⅢ>CⅣ.Conclusion In the group of hepatitis B patients at active stage,hepatic fibrosis indexes can reflect the liver fibrosis degree,and it is of great significance for clinical diagnosis,treatment effect monitoring and prognosis judgment.

关 键 词：慢性乙型肝炎 血清4项肝纤维化指标 肝纤维化 

分 类 号：R575.2[医药卫生—消化系统]