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目的 探讨肝病患者血清前Ⅲ型胶原(PⅢP)和透明质酸(HA)的含量变化及其意义。方法 放射免疫法检测201例肝病患者、30例正常人血清的PⅢP和HA含量,同时检测慢性肝炎组患者血液生化指标。结果 与健康对照组比较,除脂肪肝组外,急性肝炎、慢性肝炎轻中重度三型、肝炎后肝硬化和肝癌各组的PⅢP和HA含量均明显升高,差异有统计学意义(P<0.01),其中PⅢP在慢性肝炎(重度)为最高,HA在肝炎后肝硬化组为最高。慢性肝炎组随着病情的加重PⅢP、HA、γ-球蛋白和胆汁酸含量随之增高,而血清白蛋白(A)、白/球比例(A/G)和纤维蛋白原(FIB)水平逐渐下降,凝血酶原时间(PT)则延长。其中PⅢP、HA在轻度慢性肝炎患者就有明显改变。结论 血清PⅢP、HA在多种肝病中均有显著升高,在慢性肝炎轻型,其含量变化已很明显地高于正常值,较生化指标能更敏感地反映肝细胞损害程度。检测其含量可反映肝脏损害程度、炎症活动程度及纤维化增生程度,有助于慢性肝炎、肝硬化和肝癌的诊断,尤其对慢性肝炎轻型的诊断有较好的临床价值。
Objective To investigate the changes of serum levels of type Ⅲ collagen (Ⅲ) and hyaluronic acid (HA) in patients with liver diseases and its significance. Methods The serum levels of PⅢP and HA in 201 patients with liver disease and 30 healthy controls were detected by radioimmunoassay. Blood biochemical parameters were also measured in patients with chronic hepatitis. Results Compared with healthy control group, the levels of PⅢP and HA in acute hepatitis, chronic mild hepatitis type and severe hepatitis type Ⅲ, cirrhosis and hepatocellular carcinoma group were significantly higher than those in healthy control group (P < 0.01). Among them, PⅢP was the highest in chronic hepatitis (severe) and HA was the highest in patients with post-hepatitis cirrhosis. The levels of PⅢP, HA, γ-globulin and bile acid in the chronic hepatitis group increased with the increase of the disease, while the level of serum albumin (A), ratio of white matter / sphere (A / G) and fibrinogen Decreased, prothrombin time (PT) is prolonged. Which P Ⅲ P, HA in patients with mild chronic hepatitis have obvious changes. Conclusions Serum P Ⅲ P and HA are significantly increased in a variety of liver diseases. In the light type of chronic hepatitis, the content of P Ⅲ P and HA is obviously higher than the normal value, which reflects the degree of hepatocyte damage more sensitively than the biochemical indexes. Detection of its content can reflect the degree of liver damage, degree of inflammatory activity and fibrosis hyperplasia, contribute to the diagnosis of chronic hepatitis, cirrhosis and liver cancer, especially for the diagnosis of chronic hepatitis, light has a good clinical value.