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目的通过对肝纤维化复方中药治疗的前后对比，结合肝病理组织学改变，进一步了解血清纤维化指标的诊断价值。方法对临床确诊为慢性乙肝及早期肝硬化的３４例患者，服用复方中药制剂半年，治疗前后各肝穿一次及采血４次，血清检测透明质酸（ＨＡ），Ⅲ型前胶原（ＰＣⅢ）Ⅳ型胶原（ＣＩＶ）及层粘素（ＬＮ）。ＨＡ、ＰＣⅢ及ＬＮ用放免法，ＣＩＶ用酶免法。结果治疗前后对比，血清纤维化指标中，ＨＡ、ＰＣⅢ及ＩＮ变化非常显著（Ｐ＜０００１）；ＣＩＶ变化不明显（Ｐ＞００５）；血清纤维化四项指标与病理炎症及纤维化程度关系密切。与炎症计分的相关系数为：ＰＣⅢ：（０５２８５）、ＨＡ（０３８７７）、ＣＩＶ（０３４６４）和ＬＮ（０３３４１）；与纤维化计分的相关系数为：ＨＡ（０６２０３）、ＬＮ（０４２８９）、ＰＣⅢ（０４０９８）和ＣＩＶ（０３９７７）。结论血清纤维化指标为较好反映肝纤维化的指标，并随治疗有效而下降，其中ＨＡ对肝纤维化及早期肝硬化的诊断价值较大，ＰＣⅢ更倾向于反映活动性肝纤维化。
Objective To further understand the diagnostic value of serum fibrosis markers by comparing before and after treatment of hepatic fibrosis combined with traditional Chinese medicine, combined with liver histopathological changes. Methods Thirty-four patients with chronic hepatitis B and early cirrhosis who were clinically diagnosed took compound herbal preparations for six months. Each liver was taken once and collected four times before and after treatment. Serum levels of hyaluronic acid (HA) and type III procollagen (PCIII) IV were measured. Collagen (CIV) and Laminin (LN). Radioimmunoassay for HA, PCIII, and LN, and enzyme immunoassay for CIV. Results Before and after treatment, serum fibrosis indexes showed significant changes in HA, PCIII and IN (P<0001); CIV did not change significantly (P>005); four indicators of serum fibrosis and pathological inflammation and fiber The degree of close relationship. Correlation coefficients with inflammation scores were: PCIII: (05285), HA (03877), CIV (03464), and LN (03341); the correlation coefficient with fibrosis score was: HA ( 06203), LN(04289), PCIII(04098) and CIV(03977). Conclusions Serum fibrosis index is a good indicator of liver fibrosis and decreases with effective treatment. Among them, HA has a greater value in the diagnosis of hepatic fibrosis and early cirrhosis. PCIII is more likely to reflect active hepatic fibrosis.