CAJ | 학술논문

目的探讨慢性乙型肝炎(CHB)肝组织学纤维化程度与临床血清肝纤维化相关指标之间的关系.方法对189例人院诊断为CHB的患者行肝穿刺.同时检测血清HA、LN、PCⅢ、ⅣC、肝功能和血常规,并按组织学的不同纤维化分期(S)进行比较和相关性回归分析.结果从肝纤维化So至S4期,PC Ⅲ、γ-GT、TBil、γ-球蛋白和PT渐增,差异有统计学意义(F值分别为3.325、6.218、2.958、10.160和7.028,P＜0.05);胆碱酯酶(CHE)、总蛋白(TP)、Alb、PLT值渐减,差异有统计学意义(F值分别为15.984、3.786、14.919和4.737,P＜0.01);LN、ⅣC、ALT和AST值在S各期比较差异有统计学意义(F值分别为4.618、2.795、2.649和3.199,P＜0.05).S分期与LN、PCⅢ、ALT、AST、TBil、γ-GT、γ-球蛋白、PT呈正相关(rs值为0.200、0.306、0.1 72、0.273、0.153、0.402、0.415、0.269),与CHE、TP、Alb、PLT呈负相关(rs值为-0.502、-0.208、-0.413、-0.390);LN、ALT、CHE、PLT、γ-球蛋白为肝纤维化分期的独立影响因素(P＜0.05).结论肝组织学纤维化分期与血清肝纤维化、肝功能、血常规指标有不同程度相关.综合多项临床资料可早期无创性诊断肝纤维化.
목적 탐토만성을형간염(CHB)간조직학섬유화정도여림상혈청간섬유화상관지표지간적관계.방법 대189례인원진단위CHB적환자행간천자.동시검측혈청HA、LN、PCⅢ、ⅣC、간공능화혈상규,병안조직학적불동섬유화분기(S)진행비교화상관성회귀분석.결과 종간섬유화So지S4기,PC Ⅲ、γ-GT、TBil、γ-구단백화PT점증,차이유통계학의의(F치분별위3.325、6.218、2.958、10.160화7.028,P＜0.05);담감지매(CHE)、총단백(TP)、Alb、PLT치점감,차이유통계학의의(F치분별위15.984、3.786、14.919화4.737,P＜0.01);LN、ⅣC、ALT화AST치재S각기비교차이유통계학의의(F치분별위4.618、2.795、2.649화3.199,P＜0.05).S분기여LN、PCⅢ、ALT、AST、TBil、γ-GT、γ-구단백、PT정정상관(rs치위0.200、0.306、0.1 72、0.273、0.153、0.402、0.415、0.269),여CHE、TP、Alb、PLT정부상관(rs치위-0.502、-0.208、-0.413、-0.390);LN、ALT、CHE、PLT、γ-구단백위간섬유화분기적독립영향인소(P＜0.05).결론 간조직학섬유화분기여혈청간섬유화、간공능、혈상규지표유불동정도상관.종합다항림상자료가조기무창성진단간섬유화.
Objective To investigate the relationship between hepatic fibrosis stage and clinical serum fibrosis markers in patients with chronic hepatitis B (CHB).Methods Liver puncture biopsy was performed in 189 CHB patients.The serum levels of hyalyronic acid (HA),laminin (LN),procollagen Ⅲ (PCⅢ),collagen Ⅳ (Ⅳ C),liver function and peripheral blood routine were detected simultaneously. The comparison, correlation and regression analysis were performed based on different fibrosis stages (S).Results From SO to S4 group,levels of PC Ⅲ,γ-glutamyl transpeptidase (γ-G-T),total bilirubin (TBil),protein electrophoresis γ-globulin (Ely-γ) and prothrombin time (PT) were progressively elevated,the differences were statistically significant (F value was 3.325,6.218,2.958,10.160 and 7.028,P＜0.05),while cholinesterase (CHE),total protein (TP),albumin (Alb) and platelet (PLT) were progressively declined,the differences were also statistically significant (F value was 15.984,3.768,14.919 and 4.737,P＜0.05).The differences of LN,IVC,ALT and AST between groups were statistically significant (F value was 4.618,2.795,2.649 and 3.199,P＜0.05).Fibrosis stages (s) was positively correlated with LN,PCIII,ALT,AST,TBil,γ-GT,Ep-γand PT (r=0.200,0.306,0.172,0.273,0.153,0.402,0.415,0.269,respectively);while it was negatively correlated with CHE,TP,Alb and PLT (r=-0.502,-0.208,-0.413,-0.390,respectively);I.N,AI.T,CHE,PLT and Ep-γ were the independent risk factors which affecting hepatic fibrosis stages.Conclusions Liver fibrosis stage in histopathology was correlative in certain degree with the serum markers of hepatic fibrosis,liver function,and blood routine examination.Combined analysis of clinical data may be used to early diagnose hepatic fibrosis non-invasively.