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了解血清肝纤维化指标透明质酸(HA)、层粘蛋白(LN)、Ⅲ型前胶原(PC Ⅲ)水平与慢性肝炎病理变化的关系。方法:用放射免疫法测定13例慢性肝炎患者血清HA、LN、PCⅢ水平,同时行肝组织活检、病理切片,对肝组织进行炎症分级和纤维化分期,分析血清指标与病理分级、分期的关系。结果:将上述3项指标含量与慢性肝炎中度、肝硬变病理改变对应观察,发现其与肝组织炎症分级和纤维化分期呈正相关。以HA上升幅度大、敏感度高,LN在S_4期才升高幅度明显,PC Ⅲ主要是反映肝内成纤维活动的指标。病理变化与2项或3项异常符合率分别是38.5%与61.5%,提示血清HA、LN、PCⅢ含量能够反映慢性肝炎的严重程度,但其单项指标反映炎症活动度与纤维化程度的特异性,敏感性差。结论:开展HA、LN、PCⅢ水平的联合检测有助于提高肝纤维化的早期诊断。
To investigate the relationship between the level of serum hyaluronic acid (HA), laminin (LN) and type Ⅲ procollagen (Ⅲ) in serum and the pathological changes of chronic hepatitis. Methods: Serum levels of HA, LN and PCⅢ in 13 patients with chronic hepatitis were determined by radioimmunoassay. At the same time, biopsy and pathological sections of liver tissue were performed. Inflammatory and fibrotic staging of liver tissue was analyzed. The relationship between serum indexes and pathological grade and stage was analyzed . Results: The above three indicators of chronic hepatitis and liver cirrhosis corresponding to the pathological changes observed, and found that the inflammation grade and liver fibrosis stage was positively correlated. HA increased by a large margin, high sensitivity, LN increased significantly in the S_4 stage, PC Ⅲ mainly reflect the activity of intrahepatic fibrosis index. The coincidence rates of pathological changes with two or three abnormalities were 38.5% and 61.5% respectively, suggesting that the serum levels of HA, LN and PCⅢ can reflect the severity of chronic hepatitis, but the individual indexes reflect the specificity of inflammatory activity and fibrosis , Poor sensitivity. Conclusion: The joint detection of HA, LN and PCⅢ levels can help improve the early diagnosis of liver fibrosis.