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为寻找诊断肝纤维化敏感可靠的血清学指标,对正常人30例和各型肝病108例同时检测血清Ⅲ型前胶原肽(PⅢP)、Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)、脯氨酸肽酶(PLD)等4项指标,并与胆红素、丙氨酸转氨酶(ALT)、血浆蛋白和血小板比较。结果表明,4项指标分别在急性肝炎、慢性肝炎、肝硬化中不同程度升高,与正常人比较差异有显著意义(P<0.01)。同时显示白/球蛋白倒置时PⅢP、CⅣ、LN明显增高(P<0.01);胆红素增高时CⅣ、LN、PLD含量也相应增高(P<0.01);血小板降低时CⅣ、LN明显增高(P<0.01);而ALT除PLD含量在该值>500 U/L以上表现有意义(P<0.05),其它指标则与ALT变化无关。结论:4项指标联合检测有助于临床对肝纤维化的诊断。
In order to find the sensitive and reliable serological markers for the diagnosis of liver fibrosis, the serum levels of type Ⅲ procollagen (P Ⅲ P), type Ⅳ collagen (C Ⅳ), laminin (LN) Prolyl peptidase (PLD) and other four indicators, and with bilirubin, alanine aminotransferase (ALT), plasma protein and platelet comparison. The results showed that the four indexes were increased in acute hepatitis, chronic hepatitis and cirrhosis to some extent, which were significantly different from those in normal people (P <0.01). At the same time, PⅢP, CⅣ, LN were obviously increased when white / globulin was inverted (P <0.01); CⅣ, LN and PLD were also increased when bilirubin was increased (P <0.01) P <0.01). However, the content of PLD in ALT was significantly higher than 500 U / L (P <0.05), while the other indexes were not related to ALT changes. Conclusion: The combined detection of four indexes is helpful to the clinical diagnosis of liver fibrosis.