血清肝纤维化标志物在非酒精性脂肪性肝炎（NASH）诊断中的应用价值。

Usefulness of serum hepatic fibrosis markers in the diagnosis of nonalcoholic steatohepatitis (NASH).

作者信息

Sasaki Nozomi, Ueno Takato, Morita Yasuyo, Nagata Eisuke, Sata Michio

机构信息

Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan.

出版信息

Hepatogastroenterology. 2006 Sep-Oct;53(71):678-81.

PMID:17086867

Abstract

BACKGROUND/AIMS: In the present study, we examined the usefulness of serum hepatic fibrosis markers for the diagnosis of nonalcoholic steatohepatitis (NASH).

METHODOLOGY

The subjects were 16 patients with NASH and 9 patients with fatty liver (FL). All were negative for serum HBsAg, HCVAb, antibodies related with autoimmune diseases, alcohol intake, and drug abuse. We measured the biochemical markers for liver function, hepatic fibrosis markers such as type III procollagen N-peptide (PIIIP), type IV collagen (TyIV), hyaluronic acid (HA) and leptin, and compared these data with histological findings of biopsy specimens. In addition, we examined the diagnostic efficiency of fibrosis markers and leptin for NASH using receiver operating characteristic (ROC) curve. Body mass index (BMI), fasting blood sugar, triglyceride, and degree of fat droplets, inflammation, iron deposition and fibrosis were significantly higher in the NASH group compared with the FL group.

RESULTS

The diagnostic efficiencies of NASH% (cut-off value) were 68% (100ng/mL) for TyIV, 68% (10ng/mL) for HA, 64% (0.62U/mL) for PIIIP and 56% (8pg/mL) for leptin.

CONCLUSIONS

From these results, it is suggested that the serum hepatic fibrosis markers such as TyIV, in addition to liver biopsy, may be useful for the diagnosis of NASH.

摘要

背景/目的：在本研究中，我们检测了血清肝纤维化标志物对非酒精性脂肪性肝炎（NASH）诊断的实用性。

方法

研究对象为16例NASH患者和9例脂肪肝（FL）患者。所有患者血清乙肝表面抗原、丙肝抗体、自身免疫性疾病相关抗体、酒精摄入及药物滥用检测均为阴性。我们检测了肝功能生化标志物、肝纤维化标志物，如III型前胶原N端肽（PIIIP）、IV型胶原（TyIV）、透明质酸（HA）和瘦素，并将这些数据与活检标本的组织学结果进行比较。此外，我们使用受试者工作特征（ROC）曲线检测了纤维化标志物和瘦素对NASH的诊断效率。NASH组的体重指数（BMI）、空腹血糖、甘油三酯以及脂肪滴、炎症、铁沉积和纤维化程度均显著高于FL组。