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目的通过测定肝病患者血清胱抑素C(Cys C)和透明质酸(HA)、Ⅲ型前胶原(PcⅢ)等肝纤维化的指标,探讨Cys C与肝纤维化的关系。方法收集肝病患者320例作为研究对象,并根据临床诊断指标将其分为慢性肝炎组、肝硬化代偿组、肝硬化失代偿组及肝肾综合征组,同时收集80例健康体检者作为对照组。测定各组的血清Cys C、血肌酐(Scr)、尿素氮(BUN)、HA、PcⅢ、Ⅳ型胶原(ⅣC)和层粘连蛋白(LN)的浓度;采用SPSS 13.0统计软件进行统计学分析,各患者组与对照者之间的比对采用方差分析,P<0.05为差异有统计学意义。结果血清Cys C、HA、PcⅢ、ⅣC和LN水平随肝病的发展呈升高的趋势,与对照组之间差异有统计学意义(P<0.01),且血清Cys C水平与HA、PcⅢ、ⅣC、LN水平呈正相关,相关系数r分别是0.987 7、0.989 0、0.998 3、0.976 8(P<0.01);除肝肾综合征组外,血清Scr和BUN水平与对照组之间差异均无统计学意义。结论本研究表明血清Cys C水平随着肝病病程的进展而逐渐升高,可作为评价肝纤维化的潜在指标。
Objective To investigate the relationship between Cys C and hepatic fibrosis by measuring the serum levels of cystatin C (Cys C), hyaluronic acid (HA) and type Ⅲ procollagen (P Ⅲ) in patients with liver disease. Methods A total of 320 patients with liver disease were collected and divided into chronic hepatitis group, decompensated cirrhosis group, decompensated liver cirrhosis group and hepatorenal syndrome group according to clinical diagnostic criteria. Meanwhile, 80 healthy subjects were collected as Control group. The concentrations of serum Cys C, Scr, BUN, HA, PcⅢ, type Ⅳ collagen and laminin in each group were determined. Statistical analysis was carried out by using SPSS 13.0 statistical software, The analysis of variance between each patient group and the control group, P <0.05 for the difference was statistically significant. Results The serum levels of Cys C, HA, PcⅢ, Ⅳ C and LN tended to increase with the development of liver disease, and there was a significant difference between the two groups (P <0.01). The levels of serum Cys C and HA, PcⅢ, , LN were positively correlated, the correlation coefficients r were 0.987 7,0.989 0,0.998 3,0.976 8 (P <0.01). Except for hepatorenal syndrome group, there was no statistical difference between the levels of Scr and BUN in serum and the control group Significance of learning. Conclusion This study shows that serum Cys C level gradually increases with the progress of liver disease, which can be used as a potential index for evaluating liver fibrosis.