HA、PⅢNP、LN、CⅣ在慢性肝病及肝纤维化诊断中的临床意义

Clinical significances of HA，PⅢNP，LN and CⅣ in the diagnosis of chronic liver disease and liver fibrosis

摘要:

目的：观察肝硬化患者的透明质酸（hyaluronic acid，HA）、Ⅲ型前胶原氨基端肽（type Ⅲ procollagen amino peptide，PⅢNP）、层黏蛋白（laminin，LN）及Ⅳ型胶原（collagen Ⅳ，CⅣ）血清水平变化，探讨其变化与肝纤维化及纤维化程度的关系。方法：对2011年1月至2012年9月送检至我中心的204例肝病患者血清标本进行分析。204例肝病患者中，男124例，女80例，年龄26~67岁，平均年龄48岁；慢性肝炎轻度44例，中度50例，重度31例，肝炎后肝硬变79例。正常对照组46例，男25例，女21例，年龄22~52岁，平均年龄38岁，为我中心健康工作人员及健康体检者，无肝胆疾病史。用γ放射免疫计数器进行检测HA、PⅢNP、LN、CⅣ水平。分析肝病各组与正常对照组的差异和各组间的水平变化。结果：肝病各组血清中HA、PⅢNP、LN、CⅣ含量与正常对照组比较均有升高，差异有统计学意义（P<0.01）；且随病情发展而逐渐升高，以HA升高最为明显。结论：通过对肝炎病患者和肝硬化患者血清中HA、PⅢNP、LN及CⅣ水平进行监测，可以观察病患者的肝纤维化及纤维化程度，并将此作为病人治疗后疗效观察的指标之一。

Abstract:

Objective：To observe changes in levels of serum hyaluronic acid（HA），type Ⅲ procollagen amino peptide（PⅢNP），laminin（LN） and collagen Ⅳ（CⅣ） in patients with liver cirrhosis and to explore the relationship between changes of above indexes and de－grees of liver fibrosis. Methods：Blood samples of 204 patients with liver disease were collected in our center from January 2011 to September 2012. The 204 patients（experimental group） included 124 males and 80 females，aged from 26 to 67，48 in average；44 patients with mild chronic hepatitis，50 with moderate chronic hepatitis，31 with severe chronic hepatitis and 79 with posthepatitic cirrhosis. Forty-six health controls from staffs and physical examination persons in our center were enrolled as normal control group，including 25 males and 21 females，aged from 22 to 52，38 in average. Levels of HA，PⅢNP，LN and CⅣ were detected by γ-radia－tion immunity counter. Differences in levels of the indexes between each experimental group and normal control group were analyzed. Results：Levels of HA，PⅢNP，LN and CⅣ were elevated in each experimental group than in normal control group，with statistically significant differences（P<0.01）. Moreover，these indexes were increased gradually followed by the development of disease and the in－crease of HA levels was the most obvious. Conclusions：Serum levels of HA，PⅢNP，LN and CⅣ in patients could be used to indicate the occurrence of liver fibrosis and the degree of fibrosis and could also be used as one of the prognostic indicators after treatment.