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目的 观察慢性活动性肝炎、肝炎后肝硬化患者血、尿、腹水中血清前胶原肽 (PⅢP)含量的同步变化 ,同时进行血清PⅢP含量与转氨酶 (ALT)、总胆红素含量 (TBIL)、血清白蛋白量 (A)相关性测定 ,评价PⅢP在肝脏疾病中的诊断价值。方法 PⅢP含量测定采用放免法。结果 腹水中PⅢP含量均明显高于血清及尿中PⅢP含量 ,差异显著 (P <0 0 1) ,以 130 μg/L为临界值计算其 95 %可信区间内PⅢP敏感性分别为腹水 98 7%、血 95 3%、尿 81 5 % ,特异性分别为腹水 96 5 %、血 94 1%、尿 92 3 % ,血清PⅢP含量与ALT、TBIL呈正相关 ,与A呈负相关 ,差异显著 (P <0 0 5 )。结论 慢性活动性肝炎、肝硬化患者血、尿、腹水中PⅢP检测均可获得较高的敏感性和特异性 ,血PⅢP含量测定不仅对诊断肝纤维化有一定价值 ,在反映肝细胞坏死及肝功能损害程度方面也具有一定的临床意义
Objective To observe the changes of serum procollagen peptide (P Ⅲ P) levels in blood, urine and ascites of patients with chronic active hepatitis and posthepatitic cirrhosis, and to study the relationship between PⅢP, ALT, TBIL, Serum albumin (A) correlation determination, evaluation of PⅢP in the diagnosis of liver disease. Methods P Ⅲ P determination by radioimmunoassay. Results The content of PⅢP in ascites was significantly higher than that in serum and urine (P <0.01). The sensitivity to P Ⅲ P in the 95% CI was 130 μg / L as the cutoff value of ascites 98 7 %, Blood 95 3% and urine 81 5%. The specificities were ascitic fluid 96 5%, blood 94 1%, urine 92 3%, serum PⅢP content was positively correlated with ALT and TBIL, and negatively correlated with A P <0 0 5). Conclusion The detection of PⅢP in blood, urine and ascites of patients with chronic active hepatitis and cirrhosis can obtain high sensitivity and specificity. The measurement of blood PⅢP content not only has certain value in the diagnosis of liver fibrosis, but also can reflect the liver cell necrosis and liver Functional impairment also has some clinical significance