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为了探讨血清Ⅲ型前胶原(PCⅢ)、脯氨酸肽酶(PLD)、透明质酸(HA)和层粘连蛋白(LN)对肝纤维化的的诊断价值,本文对103例会上肝病患者血清中的这些指标的代谢变化进行了观察,并对其中23例肝活检患者中这些指标与肝纤维化程度之间的相关性进行了分析。结果发现,与正常人相比,慢活肝(CAH)和肝硬化(LC)患者血清PCⅢ,LN、HA和PLD水平明显增高(p<0.01),而慢迁肝(CPH)和急性肝炎(AH)患者上述各项指标的变化与正常人比较差异并不明显(p>0.05)。血清PCⅢ、LN、HA和PLD的异常高值趋向性地向LC和CAH集中,其升高的方向及程度与肝损病和肝纤维化发展的的方向程度保持良好的一致性。相关分析亦发现肝活检患者肝纤维化程度与其血清PCⅢ、LN、HA和PLD水平的变化呈显著正相关(n=23,r=+0.64+0,89,p<0.01)。提示血清PCⅢ、LN、HA和PLD等指标均能较好地反映肝病的慢性化程度和肝纤维化的活动水平及程度,且较少受肝细胞损伤性因素的影响。在反应肝纤维化程度方面,HA和LN似更优于PCⅢ和PLd。
In order to investigate the diagnostic value of serum PCⅢ, PLD, HA and LN on hepatic fibrosis, 103 cases of liver cirrhosis Metabolic changes in these indicators were observed and the correlation between these indicators and the degree of liver fibrosis in 23 patients with liver biopsy was analyzed. The results showed that the levels of PCⅢ, LN, HA and PLD were significantly higher in patients with chronic active liver disease (CAH) and cirrhosis (LC) than those in normal controls (p <0.01), while those with slowly evolving liver disease (CPH) and acute hepatitis AH) patients with changes in the above indicators compared with normal people was not significant (p> 0.05). The abnormally high values of serum PCⅢ, LN, HA and PLD tended to focus on LC and CAH, and the direction and extent of their elevation were in good agreement with the degree of development of liver damage and hepatic fibrosis. Correlation analysis also found that liver biopsy patients with liver fibrosis and its serum levels of PCⅢ, LN, HA and PLD was significantly positively correlated (n = 23, r = +0.64 +0.89, p <0.01). It is suggested that the indexes of serum PCⅢ, LN, HA, PLD and so on can all reflect the chronic degree of liver disease and the activity level and degree of liver fibrosis, and are less affected by the damage of hepatocyte. In response to the degree of liver fibrosis, HA and LN seem to be superior to PCIII and PLd.