Annoni G, Colombo M, Cantaluppi M C, Khlat B, Lampertico P, Rojkind M
Istituto di Medicina Interna, Università di Milano, Italy.
Hepatology. 1989 May;9(5):693-7. doi: 10.1002/hep.1840090506.
The diagnosis of alcoholic hepatitis is difficult to establish by conventional clinical and laboratory methods, and a firm diagnosis relies on liver histology. Since there are severe limitations in following patients with repeated liver biopsies, noninvasive procedures are needed to assess the presence of alcoholic hepatitis in chronic alcohol abusers. It has been suggested that serum Type III procollagen peptide levels correlates with the degree of inflammation in chronic liver disease. Since inflammation is a major histological finding in alcoholic hepatitis, we therefore studied the usefulness of measuring serum Type III procollagen peptide and laminin values in 45 consecutive chronic alcohol abusers, with or without cirrhosis, in detecting those with alcoholic hepatitis. The results showed that both Type III procollagen peptide and laminin values were elevated in all of the patients with established liver damage. However, the values were highest in those with liver cirrhosis plus alcoholic hepatitis (Type III procollagen peptide 50.4 +/- 36.4 ng per ml vs. 8.1 +/- 2.6 in controls, p less than 0.01; laminin 4.50 +/- 1.49 units per liter vs. 1.24 +/- 0.26 units per liter in controls, p less than 0.01), followed by subjects with alcoholic hepatitis alone (Type III procollagen peptide 23.5 +/- 17.6 ng per ml, p less than 0.01; laminin 2.60 +/- 1.09 units per liter, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
通过传统的临床和实验室方法很难确诊酒精性肝炎,确切诊断依赖于肝脏组织学检查。由于对患者进行反复肝脏活检存在严重局限性,因此需要采用非侵入性检查方法来评估慢性酗酒者是否患有酒精性肝炎。有人提出,血清III型前胶原肽水平与慢性肝病的炎症程度相关。鉴于炎症是酒精性肝炎的主要组织学表现,我们研究了连续45例有或无肝硬化的慢性酗酒者血清III型前胶原肽和层粘连蛋白水平在检测酒精性肝炎患者中的作用。结果显示,所有已确诊肝脏损伤的患者血清III型前胶原肽和层粘连蛋白水平均升高。然而,肝硬化合并酒精性肝炎患者的这两项指标最高(III型前胶原肽为50.4±36.4 ng/ml,对照组为8.1±2.6 ng/ml,p<0.01;层粘连蛋白为4.50±1.49 U/L,对照组为1.24±0.26 U/L,p<0.01),其次是单纯酒精性肝炎患者(III型前胶原肽为23.5±17.6 ng/ml,p<0.01;层粘连蛋白为2.60±1.09 U/L,p<0.01)。(摘要截选至250字)