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目的探讨多项血清指标联合检测对诊断肝纤维化的价值。方法用放免法和速率散射比浊法测定２６例正常人和７３例急、慢性肝病患者的血清透明质酸（ＨＡ）、Ⅲ型前胶原（ＰＣ Ⅲ）、 Ⅳ型胶原（ Ⅳ－Ｃ）、纤维连接蛋白（ＦＮ）、层粘蛋白（ＬＮ）。结果 ＨＡ、ＰＣ Ⅲ、 Ⅳ－Ｃ随肝纤维化程度而增高（ Ｐ＜０． ０１～０． ０５），慢活肝、肝硬化均较正常组和慢纤肝显著增高（ Ｐ＜０． ０１～０． ０５），ＨＡ、ＰＣⅢ在急性肝炎是即有升高，ＬＮ在急肝、慢肝、肝硬化均高于正常组（ Ｐ ＜０． ０１），ＦＮ则低于正常组（ Ｐ＜０． ０１）。 ５项指标的变化均与 γ球蛋白、Ａ／Ｇ显著相关（ Ｐ ＜０． ０１～０． ０５）。结论测定血清ＨＡ、ＰＣ Ｎ、 Ⅳ－Ｃ、ＬＮ和 ＦＮ水平和肝纤维化有较大诊断价值．ＨＡ和 ＰＣⅢ最敏感。
Objective To investigate the value of combined detection of multiple serum markers in diagnosis of hepatic fibrosis. Methods Serum hyaluronic acid (HA), type Ⅲ procollagen (Ⅲ) and type Ⅳ collagen (Ⅳ-C) were measured by radioimmunoassay and rate nephelometry in 26 normal subjects and 73 acute and chronic liver disease patients. Fibronectin (FN), Laminin (LN). Results HA, PC Ⅲ and Ⅳ-C increased with the degree of liver fibrosis (P <0.01-0.05), and were significantly higher than those in the normal group and chronic fibrosis (P <0.01) ~ 0.05), HA and PCⅢ were elevated in acute hepatitis, LN in acute liver, chronic liver and liver cirrhosis were higher than normal group (P <0.01), FN was lower than normal group (P < 0.01). The changes of 5 indexes were all significantly correlated with γ-globulin and A / G (P <0.01 ~ 0.05). Conclusion The determination of serum HA, PC N, Ⅳ-C, LN and FN levels and liver fibrosis have a greater diagnostic value. HA and PC Ⅲ the most sensitive.