【摘要】 目的探讨4项肝纤维化标志物透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)在肝病中的应用价值。方法分别选择60例健康人和472例各型肝病患者[其中急性肝炎78例,慢迁肝126例,慢活肝113例,肝硬化155例;肝硬化组按Child-pugh分级(A级42例,B级66例,C级47例)]测定上述4项指标在血清中的含量,并计算这4项指标在诊断肝硬化时的ROC曲线的线下面积。结果 (1)急性肝炎组与健康人组比较HA明显增高(P<0.01);慢迁肝组、慢活肝组、肝硬化组与健康人组比较,4项指标均明显增高(P<0.01)。(2)对肝硬化组Child-pugh分级后比较,HA、Ⅳ-C这2项指标B级比A级,C级比B级均有明显增高(P<0.01)。(3)ROC曲线表明,HA和PCⅢ在诊断肝硬化时优于LN和Ⅳ-C,灵敏度为87.7%、81.9%,特异性为73.7%、74.5%,准确性为77.8%、76.1%。结论 HA、LN、Ⅳ-C、PCⅢ血清浓度越高,肝硬化的可能性越大。更多还原

【Abstract】 Objective Objective To evaluate serum HA,LN,Ⅳ-C and PCⅢ in diagnosis of hepatitis.MethodsSerum HA,LN,Ⅳ-C and PCⅢ levels in 60 normal people and 472 patients with hepatitis were measured.Results(1) The level of serum HA was significantly higher in acute hepatitis patients than in normal persons(P<0.01),and the levels of all the four serum marks were higher in the patients with chronic persisting hepatitis,chronic active hepatitis or cirrhosis than in normal person(P<0.01).(2)According to the Child-pugh classification for cirrhosis,class B in serum HA and Ⅳ-C was higher than classA,and class C higher than class B(P<0.01).(3)Receiver operating characteristic curve showed that serum HA and PCⅢ were prior to LN and Ⅳ-C in diagnosis of liver cirrhosis.The sensitivity was 87.7% and 81.9%,the specificity 73.7% and 74.5%,and the veracity 77.8% and 76.1%.ConclusionThe higher serum HA,LN,Ⅳ-C and PCIII levels,the larger of the possibility of liver cirrhosis.更多还原