CAJ | 학술논문

目的：探讨肝病患者血清纤维结合蛋白（Fn）含量变化及其在肝纤维化中的意义。方法测定肝病组以及正常对照组血清Fn含量，同时测定血清总胆汁酸（TBA）、白蛋白（Alb）进行比较分析。结果急性肝炎组和肝癌组血清Fn与正常对照组差异无统计学意义（P＞0．05）；慢性肝炎中度、重度及肝硬化失代偿期组血清Fn含量均降低，与正常对照组差异有统计学意义（P＜0．05）。肝硬化失代偿组较其它肝病组血清Fn含量明显降低（P＜0．05）；酒精性肝硬化与病毒性肝硬化组血清Fn含量差异无统计学意义（P＞0．05）；肝硬化失代偿合并腹膜炎、消化道出血、脾功能亢进等并发症组血清Fn较无并发症组明显降低（P＜0．05）。正常对照组、急性肝炎组、肝癌组血清Fn与TBA无相关性（P＞0．05），慢性肝炎中度、重度及肝硬化失代偿组血清Fn与TBA呈负相关（r＝-0．593、-0．677、-0．714，P＜0．05）；各组血清Fn与Alb无相关性（P＞0．05）。结论血清Fn在一定程度上可反映肝细胞的功能，对于肝纤维化，尤其是肝硬化、肝硬化合并感染的诊断有一定的参考价值。Fn和TBA、Alb联合检测可明显提高肝纤维化诊断的准确性和可靠性。
목적：탐토간병환자혈청섬유결합단백（Fn）함량변화급기재간섬유화중적의의。방법측정간병조이급정상대조조혈청Fn함량，동시측정혈청총담즙산（TBA）、백단백（Alb）진행비교분석。결과급성간염조화간암조혈청Fn여정상대조조차이무통계학의의（P＞0．05）；만성간염중도、중도급간경화실대상기조혈청Fn함량균강저，여정상대조조차이유통계학의의（P＜0．05）。간경화실대상조교기타간병조혈청Fn함량명현강저（P＜0．05）；주정성간경화여병독성간경화조혈청Fn함량차이무통계학의의（P＞0．05）；간경화실대상합병복막염、소화도출혈、비공능항진등병발증조혈청Fn교무병발증조명현강저（P＜0．05）。정상대조조、급성간염조、간암조혈청Fn여TBA무상관성（P＞0．05），만성간염중도、중도급간경화실대상조혈청Fn여TBA정부상관（r＝-0．593、-0．677、-0．714，P＜0．05）；각조혈청Fn여Alb무상관성（P＞0．05）。결론혈청Fn재일정정도상가반영간세포적공능，대우간섬유화，우기시간경화、간경화합병감염적진단유일정적삼고개치。Fn화TBA、Alb연합검측가명현제고간섬유화진단적준학성화가고성。
Objective To investigate the change of serum fibronectin (Fn)level in patients with hepatopathy and the significance of Fn in hepatofibrosis.Methods Serum Fn levels in patients with hepatopathy and healthy controls were determined.Serum total bile acid (TBA)and albumin (Alb)were determined,and the results were analyzed comparatively.Results Serum Fn levels in patients with oxyhepatitis and liver cancer had no statistical significance with those in healthy controls with statistical significance (P>0.05).Serum Fn levels in patients with chronic moderate hepatitis,chronic severe hepatitis and cirrhosis were lower than those in healthy controls with statistical significance (P<0.05).Serum Fn levels in patients with cirrhosis were lower than those in other patients with hepatopathy (P<0.05).Serum Fn levels in patients with alcohol cirrhosis and virus cirrhosis had no statistical significance (P>0.05). Serum Fn levels in cirrhosis patients with complications,such as peritonitis, hemorrhage of digestive tract and hypersplenia,decreased significantly than those without complications (P<0.05 ).Serum Fn and TBA in healthy controls and patients with oxyhepatitis and liver cancer had no correlation (P>0.05 ),and had negative correlation between patients with chronic moderate hepatitis,chronic severe hepatitis and cirrhosis (r=-0.593,-0.677 and-0.71 4,P<0.05 ).Serum Fn had no correlation with Alb (P>0.05 ).Conclusions Serum Fn can reflect the function of hepatocyte in a certain extent,and has certain reference significance in the diagnosis of hepatofibrosis especially cirrhosis and cirrhosis with infection.The diagnostic accuracy and reliability of Fn determination with TBA and Alb can be obviously improved.