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目的探讨血清肝纤维化指标透明质酸（ＨＡ）、 Ⅲ型前胶原（ＰＣ Ⅲ）、 Ⅳ型胶原（Ｃ Ⅳ）水平与肝组织纤维化程度的关系及对慢性病毒性肝炎肝纤维化诊断的临床意义。方法用放射免疫祛测定１５１例慢性病毒性肝炎患者血清ＨＡ、 ＰＣ Ⅲ、 Ｃ Ⅳ水平，所有患者均做肝活组织检查，对肝组织标本行Ｍａｓｓｏｎ祛网状纤维染色。在计算机图象分析系统下对肝组织网状纤维染色标本进行纤维组织定量测定。结果血清ＨＡ、 ＰＣ Ⅲ、 Ｃ Ⅳ水平与肝组织纤维化程度一致，随着肝组织病理分期进展（Ｓ_１—Ｓ_４）及肝组织图象分析结果增加而升高，均在肝硬化阶段水平最高。血清ＨＡ、 ＰＣ Ⅲ、 Ｃ Ⅳ与肝组织分期及肝组织图象分析均呈正相关，其与分期的相关系数（ｒ）分别为０．６９４、 ０．４９３和０．５５２（Ｐ值均＜０．００１），与纤维图象分析的ｒ分别为０．７１５、０．５９６和０．５３７（Ｐ值均＜０．００１）。结论血清ＨＡ、ＰＣ Ⅲ、 Ｃ Ⅳ水平与肝组织纤维化发展的阶段性一致，可以做为反映肝纤维化程度的指标。
Objective To investigate the relationship between the levels of hyaluronic acid (HA), type Ⅲ procollagen (Ⅲ), type Ⅳ collagen (Ⅳ) and the severity of hepatic fibrosis in serum of patients with chronic hepatitis B and the clinical diagnosis of liver fibrosis significance. Methods Serum levels of HA, PC Ⅲ and C Ⅳ in 151 patients with chronic viral hepatitis were determined by radioimmunoassay. All patients underwent liver biopsy, and Masson’s retinal fibers were stained for liver tissue. Under the computer image analysis system, the liver tissue reticular fiber staining specimens were quantitatively determined. Results The levels of serum HA, PC Ⅲ and C Ⅳ were consistent with the degree of liver fibrosis. The levels of serum HA, PC Ⅲ and C Ⅳ were increased with the progress of pathological staging (S 1-S 4) and liver imaging. Serum HA, PC Ⅲ and C Ⅳ were positively correlated with liver staging and liver tissue image analysis, and the correlation coefficients (r) were 0.694, 0.493 and 0.552 respectively (all P <0 .001), and r were 0.715, 0.596 and 0.537, respectively, for fiber image analysis (P <0.001). Conclusion The serum levels of HA, PC Ⅲ and C Ⅳ are consistent with the stages of liver fibrosis, which can be used as an index to reflect the degree of liver fibrosis.