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目的 探讨肝纤维化血清学指标与慢性肝炎肝组织炎症活动度及纤维化程度的相关性。方法 324例慢性肝炎患者经肝脏活检行常规病理检查, 同时肝活检前一周内采血检测血清纤维化指标[Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(ⅣC)、透明质酸(HA)、层粘蛋白(LN)], 探讨它们与肝脏病理的关系。结果 血清PCIII、HA、IV C水平与肝组织病理分期有相关性, PCⅢ、HA水平随纤维化分期(S1→S4) 依次升高, 各期中差异有显著性; PCⅢ水平在S0 期已有明显升高。IV C水平在肝组织病理纤维化分期各期中无差异。LN水平与肝纤维化分期无相关性。血清PCⅢ、HA、ⅣC水平与肝组织病理分级有相关性, PCⅢ、HA水平随着组织病理分级而升高,各级中差异有显著性。ⅣC水平在肝组织病理分级中有差异, 但其水平不随分级而升高。结论 血清PCIII、HA水平与肝组织病理的分级和分期的相关性较好, 是反映肝纤维化程度的良好指标, 有较高的诊断价值; ⅣC、LN水平对肝纤维化的诊断价值有待进一步研究。PCⅢ可能对肝纤维化的早期诊断有意义
Objective To investigate the relationship between the serum markers of liver fibrosis and inflammatory activity and fibrosis in liver tissues of chronic hepatitis. Methods A total of 324 patients with chronic hepatitis were examined by liver biopsy routinely. Blood samples were taken from one week before liver biopsy to detect the serum levels of PC Ⅲ, ⅣC, HA, Mucin (LN)], to explore their relationship with the liver pathology. Results Serum levels of PCIII, HA and IVC were correlated with pathological stages of liver. The levels of PC Ⅲ and HA increased with the stages of fibrosis (S1 → S4), and the difference was significant in each stage. The levels of PCⅢ in stage S0 Significantly increased. The level of IV C was not different in all stages of hepatic fibrosis stage. LN level and liver fibrosis stage no correlation. Serum levels of PCⅢ, HA and ⅣC were correlated with pathological grade of liver tissue. The levels of PC Ⅲ and HA increased with histopathological grade, and there was significant difference at all levels. The level of IVC was different in pathological grading of liver, but its level did not increase with grading. Conclusions Serum levels of PCIII and HA correlate well with the grade and stage of liver pathology, which is a good indicator to reflect the degree of liver fibrosis and have high diagnostic value. The diagnostic value of Ⅳ C and LN in liver fibrosis needs to be further studied the study. PC Ⅲ may be of significance for the early diagnosis of liver fibrosis