中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2013年
18期
2796-2798
,共3页
肝硬化%肝炎,乙型,慢性
肝硬化%肝炎,乙型,慢性
간경화%간염,을형,만성
Liver cirrhosis%Hepatitis B,chronic
目的 探讨血清肝纤维化指标联合测定对慢性乙型肝炎(慢乙肝)患者肝纤维化程度的评估价值.方法 选择275例慢乙肝患者作为慢性肝炎组,根据病情程度分为慢性轻度肝炎组75例、慢性中度肝炎组72例、慢性重度肝炎组65例、肝炎后肝硬化组63例.另外选择50例体检健康人群作为健康对照组.采用化学发光免疫分析法分别测定和比较各组研究对象的血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)四个肝纤维化指标,另外比较不同指标联合的诊断结果.结果 慢性肝炎各组HA、PCⅢ、Ⅳ-C、LN指标均明显高于健康对照组(t=2.567、2.687、2.811、2.741,均P＜0.01)；四项肝纤维化指标水平均随病情的加重以及病程的延长而逐渐升高(t=2.665、2.787、2.755、2.811,均P＜0.01)；PCⅢ、IV-C、LN、HA的浓度-时间曲线面积(AUC)分别为0.680、0.825、0.716、0.826；在指标组合中以HA+PCⅢ+IV-C的诊断价值最高.结论 应用化学发光法动态检测肝纤维化四项指标是指导临床判断肝纤维化程度的非损伤性的良好检测方法.
目的 探討血清肝纖維化指標聯閤測定對慢性乙型肝炎(慢乙肝)患者肝纖維化程度的評估價值.方法 選擇275例慢乙肝患者作為慢性肝炎組,根據病情程度分為慢性輕度肝炎組75例、慢性中度肝炎組72例、慢性重度肝炎組65例、肝炎後肝硬化組63例.另外選擇50例體檢健康人群作為健康對照組.採用化學髮光免疫分析法分彆測定和比較各組研究對象的血清透明質痠(HA)、層粘連蛋白(LN)、Ⅲ型膠原(PCⅢ)、Ⅳ型膠原(Ⅳ-C)四箇肝纖維化指標,另外比較不同指標聯閤的診斷結果.結果 慢性肝炎各組HA、PCⅢ、Ⅳ-C、LN指標均明顯高于健康對照組(t=2.567、2.687、2.811、2.741,均P＜0.01)；四項肝纖維化指標水平均隨病情的加重以及病程的延長而逐漸升高(t=2.665、2.787、2.755、2.811,均P＜0.01)；PCⅢ、IV-C、LN、HA的濃度-時間麯線麵積(AUC)分彆為0.680、0.825、0.716、0.826；在指標組閤中以HA+PCⅢ+IV-C的診斷價值最高.結論 應用化學髮光法動態檢測肝纖維化四項指標是指導臨床判斷肝纖維化程度的非損傷性的良好檢測方法.
목적 탐토혈청간섬유화지표연합측정대만성을형간염(만을간)환자간섬유화정도적평고개치.방법 선택275례만을간환자작위만성간염조,근거병정정도분위만성경도간염조75례、만성중도간염조72례、만성중도간염조65례、간염후간경화조63례.령외선택50례체검건강인군작위건강대조조.채용화학발광면역분석법분별측정화비교각조연구대상적혈청투명질산(HA)、층점련단백(LN)、Ⅲ형효원(PCⅢ)、Ⅳ형효원(Ⅳ-C)사개간섬유화지표,령외비교불동지표연합적진단결과.결과 만성간염각조HA、PCⅢ、Ⅳ-C、LN지표균명현고우건강대조조(t=2.567、2.687、2.811、2.741,균P＜0.01)；사항간섬유화지표수평균수병정적가중이급병정적연장이축점승고(t=2.665、2.787、2.755、2.811,균P＜0.01)；PCⅢ、IV-C、LN、HA적농도-시간곡선면적(AUC)분별위0.680、0.825、0.716、0.826；재지표조합중이HA+PCⅢ+IV-C적진단개치최고.결론 응용화학발광법동태검측간섬유화사항지표시지도림상판단간섬유화정도적비손상성적량호검측방법.
Objective To explore the value of combined determination of serum hepatic fibrosis index for evaluation on the degree of liver fibrosis in patients with chronic hepatitis B(HBV).Methods 275 patients with HBV were selected as chronic hepatitis group,which were divided into the mild chronic hepatitis group(75 cases),chronic moderate hepatitis group (72 cases),chronic severe hepatitis group (65 cases),liver cirrhosis group (63 cases) according to the severity of disease.In addition,50 healthy population were selected as the healthy control group.The four liver fibrosis indicators included serum hyaluronic acid(HA),laminin (LN),collagen type Ⅲ (PC Ⅲ),type IV collagen(IV-C) were determined by chemiluminescence immunoassay and compared among the groups,and the diagnostic results of combined different indicators were compared.Results The indexes of HA,PC Ⅲ,IV-C,LN were significantly higher than those of the healthy control group (t =2.567,2.687,2.811,2.741,all P ＜ 0.01).The hepatic fibrosis indexes were increased by with the severity and duration increased gradually (t =2.665,2.787,2.755,2.811,all P ＜ 0.01).The concentration-time curves area (AUC) of PC Ⅲ,Ⅳ-C,LN,HA were 0.680,0.825,0.716,0.826,respectively.Diagnosis value of three combination indicators in HA + PC Ⅲl + Ⅳ-C was highest.Conclusion The chemiluminescence dynamic detection of four liver fibrosis indicators is a good non-invasive detection method for guiding clinical diagnosis on the degree of liver fibrosis.
