血清透明质酸、Ⅲ型前胶原、Ⅳ型胶原水平与肝纤维化的....docVIP

血清透明质酸、Ⅲ型前胶原、Ⅳ型胶原水平与肝纤维化的... 血清透明质酸、Ⅲ型前胶原、Ⅳ型胶原水平与肝纤维化的关系 2010-09-05 谢仕斌　姚集鲁　郑荣琴　谢冬英　高志良 　　【摘要】　目的　研究血清纤维化指标透明质酸(HA)、Ⅲ型前胶原(PC Ⅲ)及Ⅳ型胶原(Ⅳ C)水平与肝纤维化程度的关系。方法　用放射免疫法测定114例慢性乙型肝炎(CHB)患者血清HA、ⅣC及PC Ⅲ水平，同时行肝组织活检，对肝组织进行炎症分级和纤维化分期。分析上述血清指标水平与肝组织分级和分期之间的关系。结果　上述指标水平均与慢性肝炎发展的阶段一致，在慢性重度与肝硬化阶段均处于最高水平，与肝组织炎症坏死及纤维化程度亦一致，在炎症分级G4、纤维化分期S4水平最高。血清HA、PCⅢ及ⅣC水平与肝组织炎症坏死和纤维化程度均呈正相关，但与纤维化的相关性均高于与炎症坏死相关性。结论　血清HA、ⅣC及PCⅢ可以做为反映肝纤维化程度的指标之一。 　　【关键词】　透明质酸　　Ⅲ型前胶原　　Ⅳ型胶原　　慢性肝炎　肝硬化 A Study on the relationship between serum levels of hyaluronic acid, type Ⅲ procollagen, type Ⅳ collagen and hepatic fibrosis XIE Shibing, YAO Jilu, ZHENG Rongqin, et al. Department of Infectious Diseases, Thrid Affiliated Hospital, Sun Yat-sen University of Medical Science, Guangzhou 510630 　　【Abstract】　Objective　To study the relationship between levels of hyaluronic acid (HA), type Ⅲ procollagen (PCⅢ), type Ⅳ collagen (ⅣC) and hepatic fibrosis.Methods　These 3 serum components were measured in 114 patients with chronic hepatitis B(CHB) by radioimmunoassay. Liver biopsy as well as serum HA, PCⅢ and ⅣC detection were performed at the same time in all patients, the results of which were compared with hepatic histological findings diagnosed by the standard of hepatic histological grade and stage.Results　Serum concentration of HA, PCⅢ and ⅣC were increased with the progression of disease, and reached the highest leves in liver cirrhosis. These components were also increased with the progression of hepatic histological grade and stage, and reached the highest levels in grade 4 and stage 4. The serum levels of HA、PC Ⅲ and ⅣC all were positively correlated with inflammation activity and fibrosis of the liver (P＜0.05), but more closely correlated with hepatic fibrosis.Conclusion　The results suggest that determination of serum HA、PCⅢ and ⅣC may be of value in diagnosing hepatic fibrosis. 　　【Key words】　Hyaluronic acid　　Type Ⅲ procollagen　　Type Ⅳ collagen　　Chronic hepatitis B　　Liver cirrhosis 　　由于肝穿刺难于重复开展，近年来人们较注重研究血清纤维化指标对肝纤维化