CAJ | 학술논문

目的寻找反映慢性肝病肝纤维化进展程度敏感可靠的血清学诊断指标。方法对184例住院肝病患者联合检测血清Ⅲ型前胶原(PCⅢ)、透明质酸(HA)、层粘蛋白(LN)、甲胎蛋白(AFP)、铁蛋白(SF)、癌胚抗原(CEA)。并与8例肝组织学检查及30例无肝病史及肝功能异常的常规体格检查者进行对照研究。结果六项指标阳性率在慢性肝炎轻度(CHⅠ)、急性肝炎(AVH)、慢性肝炎中度(CHⅡ)、慢性肝炎重度(CHⅢ)、肝硬变(LC)、肝细胞癌(HCC)及慢性重型肝炎(CHG)各组间，依序递增，与各级肝病中肝纤维化程度及临床病情的轻重有良好的相关性。结论联合检测血清PCⅢ、HA、LN、AFP、SF、CEA可明显提高慢性肝病诊断的准确性与可靠性，作为判断肝纤维化、肝硬变程度及有无伴发肝癌的良好指标，重复性好，无创伤，便于掌握病变进展情况。
목적심조반영만성간병간섬유화진전정도민감가고적혈청학진단지표。방법대184례주원간병환자연합검측혈청Ⅲ형전효원(PCⅢ)、투명질산(HA)、층점단백(LN)、갑태단백(AFP)、철단백(SF)、암배항원(CEA)。병여8례간조직학검사급30례무간병사급간공능이상적상규체격검사자진행대조연구。결과륙항지표양성솔재만성간염경도(CHⅠ)、급성간염(AVH)、만성간염중도(CHⅡ)、만성간염중도(CHⅢ)、간경변(LC)、간세포암(HCC)급만성중형간염(CHG)각조간，의서체증，여각급간병중간섬유화정도급림상병정적경중유량호적상관성。결론연합검측혈청PCⅢ、HA、LN、AFP、SF、CEA가명현제고만성간병진단적준학성여가고성，작위판단간섬유화、간경변정도급유무반발간암적량호지표，중복성호，무창상，편우장악병변진전정황。
Objective To sutdy sensitive and reliable serum markers of liver fibrosis in patients with chronic hepatic diseases for early clinical diagnosis．Methods We carried out co-detection of serum PCⅢ，HA，LN，AFP，SF，CEA in 184 cases compared with liver biopsy samples of 8 cases and the routine examination of 30 cases without chronic hepatic disease and abnormal liver function．Results The positive rates of the six markers increased in order of precedence in the chromic hepatitis（light）（CHⅠ），the acute hepatitis（AVH），chronic hepatitis（middle）（CHⅡ），chronic hepatitis（heavy）（CHⅢ），cirrhosis of liver（LC），hepatocellular carcinoma（HCC）and chronic hepatitis（grave）（CHG），which were corelated closely to the degree of hepatic fibrosis and the clinical condition．Conclusion The co-detection of six markers can improve the accuracy and reliability of clinical diagnosis in chronic hepatic diseases，and can be considered to be good markers for judgement of the fibrosis of liver and hepatocarcinoma．