[IV型胶原和透明质酸在丙型肝炎患者血清中对肝纤维化分期的诊断意义]

[Diagnostic significance of type IV collagen and hyaluronic acid in the serum of patients with chronic hepatitis C for staging hepatic fibrosis].

作者信息

Iushchuk N D, Znoĭko O O, Safiullina N Kh, Dudina K R, Kelli E I, Klimova E A, Kashirin V I, Braginskiĭ D M, Kushlinskiĭ N E, Liubimova N V, Vasilev A Iu, Penkina T V, Danilin A G

出版信息

Ter Arkh. 2005;77(4):50-5.

PMID:15938533

Abstract

AIM

To evaluate diagnostic value of serologic fibrosis markers (hyaluronic acid--HA and type IV collagen C-IV) in patients with chronic hepatitis C (CHC) and hepatic cirrhosis (HC).

MATERIAL AND METHODS

HA and C-IV were measured in 88 CHC patients with fibrosis stage 1 (n = 63) and 3 (n = 25), 13 patients with acute hepatitis C (AHC), 28 patients with hepatic cirrhosis (HC), 19 patients with pulmonary fibrosis (PF). The control group consisted of 32 healthy subjects.

RESULTS

HA concentrations in the serum of CHC patients with mild to severe inflammation and fibrosis (F1 and F3) were normal (100 ng/ml). For HC diagnosis, HA test proved highly sensitive and specific (in HA 100 ng/ml sensitivity was 100%, specificity 84.6%), but this method cannot stage hepatic fibrosis. HA test was inferior to C-IV test. A mean C-IV concentration in the serum of CHC patients at the stage of marked fibrosis (F3) is significantly higher than in F1, in HC (A) patients higher than in patients with CHC F3.

CONCLUSION

It is shown than concentration of C-IV above 196 ng/ml can differentiate fibrosis stage 1 from stage 3 with specificity 58.7 and sensitivity 88%.

摘要

目的

评估血清纤维化标志物（透明质酸——HA和IV型胶原C-IV）对慢性丙型肝炎（CHC）和肝硬化（HC）患者的诊断价值。

材料与方法

检测了88例CHC患者（纤维化1期，n = 63；3期，n = 25）、13例急性丙型肝炎（AHC）患者、28例肝硬化（HC）患者、19例肺纤维化（PF）患者的HA和C-IV水平。对照组由32名健康受试者组成。

结果

轻度至重度炎症及纤维化（F1和F3）的CHC患者血清中HA浓度正常（100 ng/ml）。对于HC诊断，HA检测显示出高度敏感性和特异性（HA 100 ng/ml时，敏感性为100%，特异性为84.6%），但该方法无法对肝纤维化进行分期。HA检测不如C-IV检测。显著纤维化（F3）阶段的CHC患者血清中C-IV平均浓度明显高于F1阶段，HC（A）患者高于CHC F3患者。