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目的:探讨抗核抗体(ANA)与血清透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、层黏蛋白(LN)、Ⅳ型胶原(Ⅳ-C)联合检测在肝病诊断中的意义。方法:采用间接免疫荧光法(IIF)、放射免疫分析法和酶联免疫法(ELISA)检测72例慢性丙肝患者的血清ANA,HA,LN,PCⅢ和Ⅳ-C水平,并与由年龄、血小板计数、γ-谷氨酰转肽酶及透明质酸四项指标构成的判别肝纤维化程度的指数模型(FibroIndex)比较,同时与48例健康体检者比较。结果:慢性丙型病毒性肝炎(丙肝)患者的血清HA,LN,PCⅢ和Ⅳ-C水平与对照组比较,均有不同程度升高(P<0.01),且随着病程的发展逐渐升高。结论:血清HA,LN,PCⅢ和Ⅳ-C可较好地反映肝纤维化程度,与ANA联合检测可提高对慢性丙肝肝纤维化的诊断水平。
Objective: To investigate the significance of combined detection of antinuclear antibody (ANA), serum hyaluronic acid (HA), type Ⅲ procollagen (PC Ⅲ), laminin (LN) and type Ⅳ collagen in the diagnosis of liver disease. Methods: The levels of serum ANA, HA, LN, PCⅢ and Ⅳ-C in 72 patients with chronic hepatitis C were detected by indirect immunofluorescence assay (IIF), radioimmunoassay and enzyme linked immunosorbent assay (ELISA) Count, γ-glutamyl transpeptidase and hyaluronic acid four indicators constitute a degree of discrimination index of liver fibrosis (FibroIndex) comparison, at the same time and 48 cases of healthy subjects were compared. Results: The levels of serum HA, LN, PCⅢ and Ⅳ-C in patients with chronic hepatitis C were significantly higher than those in controls (P <0.01), and gradually increased with the progression of disease . Conclusion: The serum levels of HA, LN, PCⅢ and Ⅳ-C can reflect the degree of liver fibrosis better. Combined with ANA can improve the diagnosis of chronic hepatitis C liver fibrosis.