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目的探讨检测肝病患者血清透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)和Ⅳ型胶原(Ⅳ-C)的临床意义。方法采用放射免疫法测定肝脏疾病患者(A组,60例)和健康人群(B组,100例)血清HA、LN、PC-Ⅲ和Ⅳ-C水平,分析其与肝脏疾病的关系。A组包括肝硬化(HC,8例)、肝癌(LC,4例)、慢性病毒性肝炎(CPH,30例)和急性病毒性肝炎(AIH,18例)患者。结果 A组HA、LN、PC-Ⅲ和Ⅳ-C水平由高到低分别为HC、LC、CPH和AIH;HC组的4项指标分别为(481.1±42.2)ng/ml、(252.3±30.6)ng/ml、(263.1±40.4)ng/ml和(239.1±39.3)ng/ml,均明显高于B组的(51.1±12.5)ng/ml、(59.43±20.4)ng/ml、(63.4±20.4)ng/ml和(54.4±14.4)ng/ml(P<0.05),亦明显高于LC、CPH和AIH组(P<0.05)。结论血清HA、LN、PC-Ⅲ和Ⅳ-C水平能反映肝纤维化的程度,可用于肝硬化的早期诊断和肝脏疾病病情的动态评估。
Objective To investigate the clinical significance of detecting serum hyaluronic acid (HA), laminin (LN), type Ⅲ procollagen (PC-Ⅲ) and type Ⅳ collagen (Ⅳ-C) Methods Serum levels of HA, LN, PC-Ⅲ and Ⅳ-C were measured by radioimmunoassay in patients with liver disease (group A, n = 60) and healthy people (group B, n = 100), and their relationship with liver disease was analyzed. Group A included patients with liver cirrhosis (HC, 8 cases), liver cancer (LC, 4 cases), chronic viral hepatitis (CPH, 30 cases) and acute viral hepatitis (AIH, 18 cases). Results The levels of HA, LN, PC-Ⅲ and Ⅳ-C in group A were HC, LC, CPH and AIH from high to low respectively. The four indexes in HC group were (481.1 ± 42.2) ng / (51.1 ± 12.5) ng / ml, (59.43 ± 20.4) ng / ml, (63.4 ± 20.4) ng / ml, (263.1 ± 40.4) ± 20.4 ng / ml and 54.4 ± 14.4 ng / ml respectively (P <0.05), and also significantly higher than those in LC, CPH and AIH groups (P <0.05). Conclusion The serum levels of HA, LN, PC-Ⅲ and Ⅳ-C can reflect the degree of liver fibrosis and can be used for the early diagnosis of liver cirrhosis and the dynamic assessment of liver disease.