血清纤维化指标与血清蛋白电泳对肝病诊断意义.docVIP

血清纤维化指标与血清蛋白电泳对肝病诊断意义 　　【摘要】 目的 本文通过检测乙型肝炎患者血清肝纤维化指标,总蛋白(TP)、白蛋白(ALB)的含量,及血清蛋白电泳分析,以探讨上述指标联合应用对肝病的诊断价值。方法 乙型肝炎患者420例(汉族220例,维族200例),诊断为急性肝炎组79例、慢性肝炎组164例、重型肝炎组81例、肝炎肝硬化组96例为实验组。以本院健康体检者100例(汉族50例,维族50例)为对照组。用放射免疫试剂盒分析血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原蛋白(Ⅳ?C)水平,用全自动生化分析仪测定血清TP、ALB、白蛋白、球蛋白A、G值。用琼脂糖凝胶电泳进行血清蛋白电泳分析。结果 各实验组患者肝纤维化指标平均值较对照组均有所升高。重型肝炎组、肝炎肝硬化组的HA、LN、PCⅢ、Ⅳ?C平均值较急性肝炎组明显升高(P 　　【关键词】乙型肝炎;肝纤维化;血清蛋白电泳 　　 　　The diagnostic value of the combined detection of hepatic fibrosis and serum protein electrophoresis for hepatic diseases 　　TIAN Yong?fang,PANG Xiu?hui,GUO Shu?li,et al.Clinical Laboratory,People’s Hospital of Xin Jiang,Urumqi,Xin Jiang 830001,China 　　【Abstract】 Objective To explore the diagnostic value of the combined detection of hepatic fibrosis,total protein,albumin,and serum protein electrophoresis for hepatic diseases.Methods A total of 420 hepatitis Bpatients(220 cases were Han,200 cases were Uygur)were divided into acute hepatitis group 79 cases,chronic hepatitis group 164 cases,severe hepatitis group 81 cases,cirrhosis group 96 cases according to diagnosis as the test groups,100 healthy subjects(50 cases were Han,50 cases were Uygur)were chosen as control group.Hyaluronic acid(HA),Laminin(LN),Procolla?gen type Ⅲ(PC Ⅲ),Ⅳ collagen(Ⅳ?C)were detected by radio immunity analysis method,Serum levels of TP,ALB and the A/G ratio were detected by Automatic biochemical analyzer,serum protein electrophoresis was analyzed by Hydrasys Sebia electrophoresis system.Results The hepatic fibrosis of the test groups were higher than those of the control and the level of HA,LN,PC Ⅲ,Ⅳ?C of severe hepatitis group and cirrhosis group were significantly higher than that of acute hepatitis group(P0.05),具有可比性。诊断标准参照《病毒性肝炎防治方案》[1];剔除标准:有甲肝病毒(HAV)、丙肝病毒(HCV)、戊肝病毒(HEV)感染及其他原因引起的急慢性肝损害等。 　　1.2 方法 　　1.2.1 标本采集 在受检者知情同意后,抽取清晨空腹静脉血,当日无法测定的标本及时分离血清,?20℃保存,1周内测定。 　　1.2.2 肝脏纤维化指标的测定 透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PC Ⅲ)、Ⅳ型胶原蛋白(Ⅳ?C)均采用放射免疫分析法,测定仪器为MPC?1型微孔板单光子计数仪,每周测定一次,试剂