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慢性肝炎患者血清纤维化指标的测定及其意义

Determination of serum fibrosis indexes in patients with chronic hepatitis and its significance.

作者信息

Zheng Min, Cai Weimin, Weng Honglei, Liu Ronghua

机构信息

Institute of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Chin Med J (Engl). 2003 Mar;116(3):346-9.

Abstract

OBJECTIVES

To study the relationship between serum levels of hyaluronic acid (HA), type III procollagen (PCIII), laminin (LN), type IV collagen (IV-C) and hepatic fibrosis and to determine their value in clinical practice.

METHODS

2600 serum samples from chronic hepatitis patients were assayed for fibrosis indexes including HA, PCIII, LN and IV-C with RIA. Liver biopsy was performed in 280 of those patients and the biopsy material was examined histopathologically. The inflammation grade of the liver, stage of fibrosis and degree of chronic hepatitis were recorded and were compared with fibrotic indexes.

RESULTS

Among 2600 chronic hepatitis patients, every fibrotic index had a significant correlation with the inflammation grade, fibrosis staging and the degree of chronic hepatitis (P < 0.01). The coefficient correlation of the results of histopathological examinations to HA was 0.544, 0.548 and 0.468 respectively, that to PCIII, 0.495, 0.424 and 0.335, that to LN, 0.214, 0.204 and 0.184, and that to IV-C, 0.406, 0.404 and 0.412, respectively.

CONCLUSIONS

Serum fibrosis indexes are fairly well correlated with the inflammation grade of the liver, fibrosis staging and the degree of chronic hepatitis. However, as diagnostic markers, they should be considered in combination with liver function tests, ultrasonography and clinical manifestations.

摘要

目的

研究血清透明质酸(HA)、Ⅲ型前胶原(PCIII)、层粘连蛋白(LN)、Ⅳ型胶原(IV - C)水平与肝纤维化的关系,并确定其在临床实践中的价值。

方法

采用放射免疫分析法(RIA)检测2600例慢性肝炎患者血清中的纤维化指标,包括HA、PCIII、LN和IV - C。其中280例患者进行了肝活检,并对活检材料进行组织病理学检查。记录肝脏炎症分级、纤维化分期及慢性肝炎程度,并与纤维化指标进行比较。

结果

在2600例慢性肝炎患者中,各项纤维化指标与炎症分级、纤维化分期及慢性肝炎程度均呈显著相关(P < 0.01)。组织病理学检查结果与HA的相关系数分别为0.544、0.548和0.468,与PCIII的相关系数分别为0.495、0.424和0.335,与LN的相关系数分别为0.214、0.204和0.184,与IV - C的相关系数分别为0.406、0.404和0.412。

结论

血清纤维化指标与肝脏炎症分级、纤维化分期及慢性肝炎程度有较好的相关性。然而,作为诊断标志物,应结合肝功能检查、超声检查及临床表现综合考虑。

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