Weigand K, Zaugg P Y, Frei A, Zimmermann A
Hepatology. 1984 Sep-Oct;4(5):835-8. doi: 10.1002/hep.1840040506.
To evaluate the diagnostic and prognostic significance of the N-terminal propeptide of collagen Type III (Col 1-3) in chronic liver disease, the peptide level was measured in the serum of 4 patients with primary biliary cirrhosis, 5 with chronic persistent hepatitis, 12 with chronic active hepatitis, and 1 with autoimmune hepatitis, for a period of 2 to 10 years and compared with liver function and histology. In primary biliary cirrhosis, Col 1-3 peptide levels were always elevated, regardless of medical therapy; however, after liver transplantation in one patient, the Col 1-3 peptide level decreased. In chronic persistent hepatitis, the peptide level fluctuated around the upper limit of normal. Among patients with chronic active hepatitis, the Col 1-3 peptide level normalized in 2 patients during remission, but was elevated in 7 patients who developed cirrhosis. Only in a patient with autoimmune hepatitis was the Col 1-3 peptide level normal, although the patient developed cirrhosis during prednisone therapy. When prednisone was withdrawn, the Col 1-3 peptide level increased. The data suggest that the serum Col 1-3 peptide may estimate the course of liver fibrosis in chronic liver disease and has prognostic value, particularly in chronic active hepatitis. Persistent elevation suggests ongoing fibrosis and development of cirrhosis; normalization suggests remission.
为评估Ⅲ型胶原N端前肽（Col 1-3）在慢性肝病中的诊断及预后意义，对4例原发性胆汁性肝硬化患者、5例慢性持续性肝炎患者、12例慢性活动性肝炎患者及1例自身免疫性肝炎患者的血清进行了为期2至10年的Col 1-3肽水平检测，并与肝功能及组织学结果进行比较。在原发性胆汁性肝硬化患者中，无论接受何种药物治疗，Col 1-3肽水平始终升高；然而，1例患者肝移植后，Col 1-3肽水平下降。在慢性持续性肝炎患者中，肽水平在正常上限附近波动。在慢性活动性肝炎患者中，2例缓解期患者的Col 1-3肽水平恢复正常，但7例发展为肝硬化的患者该肽水平升高。仅1例自身免疫性肝炎患者的Col 1-3肽水平正常，尽管该患者在泼尼松治疗期间发展为肝硬化。停用泼尼松后，Col 1-3肽水平升高。数据表明，血清Col 1-3肽可能有助于评估慢性肝病肝纤维化的进程，具有预后价值，尤其在慢性活动性肝炎中。持续升高提示肝纤维化持续存在及肝硬化的发生；恢复正常提示病情缓解。
