血清肝纤维化指标在各型肝病诊断中的应用

探讨联合检测层粘连蛋白（LN）、IV型胶原（C IV）、血清透明质酸（HA）和Ⅲ型前胶原（PCⅢ）在肝纤维化诊断中的应用价值。采用放射免疫分析法检测143例肝病患者的LN、C IV、HA、PCⅢ,同时与41名健康体检者进行比较。结果显示：各组肝病患者血清肝纤维化指标均高于正常对照组（P〈0.01）,且与慢性肝炎病情严重程度密切相关,在慢性肝炎重度组和肝硬化组中表达最高,以HA、PCⅢ升高最为显著。结论：血清LN、C IV、HA、PCⅢ联合检测可明显提高肝纤维化诊断的准确性和可靠性,对诊断肝纤维化有较高的临床价值,但不能用于慢性肝炎重度和肝硬化的鉴别诊断。

Application of Serum Hepatic Fibrosis Indices in the Diagnosis of Hepatic Disease

To investigate the significance of combined detection of laminin(LN),collagen type Ⅳ(CIV),hyaluronic acid(HA) and precollagen type Ⅲ(PCⅢ) in the diagnosis of hepatic fibrosis.The serum levels of LN,CIV,HA and PCⅢ in 143 patients with hepatic disease and 41 healthy controls were measured by radioimmunoassay(RIA).The results showed that the serum levels of LN,CIV,HA and PCⅢ in patients with hepatic disease were significantly higher than those of the control group(P<0.01),and the serum levels of those markers were related to the severity of the chronic hepatic disease.The highest serum levels were found in serious chronic hepatitis group and hepatic fibrosis group,and the increase of serum HA and PCⅢ was most remarkable.Combined detection of LN,CIV,HA and PCⅢ is a sensitive and reliable method in the diagnosis of hepatic fibrosis,but the four serum indices can not be used in differentiating serious chronic hepatitis and hepatic fibrosis.