Correlational Research of Platelet-derived Growth Factor（PDGF）-BB and Chronic Hepatitis B

Objective To explore the relevance of CHB patients＇ serum levels of PDGF-BB with their ages, sexes, medical histories, serum HBVDNA levels, liver function and Liver Fibrosis markers （HA, CⅣ, PCⅢ, LN）, and relevance between serum levels of PDGF-BB and CHB patients＇ liver fibrosis degrees. Methods （1） 74 CHB patients with serum levels of PDGF-BB and their ages, sexes, medical histories, serum HBVDNA levels, liver functions and serum hepatic fibrosis markers （HA, CⅣ, PCⅢ, LN） to conduct an analysis of their relations; （2） 74 CHB patients were divided into three groups： mild, moderate and severe, and analyzed the relevance of PDGF-BB levels and serum HBVDNA levels, hepatic fibrosis and liver functions. Results （1） serum levels of PDGF-BB have no significant correlation with CHB patients＇ ages, sexes, medical histories and HBVDNA （P〉0.05）; but liver function parameters and serum HA, PCIH, CIV, LN were significantly correlated （P〈0.01）; （2） PDGF-BB levels in serum and liver fibrosis markers： HA, PCⅢ, CⅣ, LN level and liver function were positively correlated （P〈0.01）; （3） PDGF-BB levels in serum and hepatic fibrosis markers： HA, PCⅢ, CⅣ, LN level were positively correlated （P 〈0.01）. Conclusions （1） The extent of the development of liver fibrosis in CHB patients is not determined by their ages, sexes, the length of a histories or the levels of HBVDNA. Liver inflammation activity is the beginning promote in the development of liver fibrosis, which decide the extent of fibrosis; the levels of serum PDGF-BB not only can reflect the CHB patients with liver damage but also can reflect the degree of liver fibrosis; （2） It can be used in CHB patients＇ liver function and fibrosis assessment.     

Clinical study on treatment of liver fibrosis of chronic hepatitis B patients with Ginkgo leaf

Objective: To study the anti-liver fibrosis effect of Ginkgo leaf in patients with chronic hepatitis B.Methods: Eighty-six patients with chronic hepatitis B were randomly divided into two groups with similar general condition. The 42 patients in the treated group were treated with Ginkgo leaf tablet (GLT), and the 44 patients in the control group were treated with Yiganling tablet (益肝灵片). The treatment was conducted for 3 successive months in both groups. Changes in the histo-pathology of liver, serum levels of platelet activating factor (PAF), hyaluronic acid (HA), collagen type Ⅳ (C-Ⅳ), laminin (LN) and pro-collagen peptide type Ⅲ (PCⅢ)were observed before and after treatment. Results: The markedly effective rate and the total effective rate in the treated group were 45.1% and 76.2% respectively, while in the control group the corresponding rates were 18.2% and 43.2%. Comparison between the two groups showed significant difference (P<0.01). Serum levels of PAF, HA, C-Ⅳ, LN and PCⅢ were lowered significantly in the treated group after treatment. Compared with the corresponding parameters in the control group after treatment, the differences were all significant (P<0.01 or P<0.05). The pathological examination of liver showed improvement in both groups, the inflammation grade lowered in 10 patients (55.6%) of the treated group and in 5 patients (35.7%) of the control group, insignificant difference was shown between them. But in comparing the fibrosis staging lowering patients between the two groups, 12 patients (66.7%) vs 3 patients (21.4%), the difference was significant (P<0.05). Moreover, there were 4 patients in the control group with their fibrosis aggravated, while in the treated group, none was aggravated (P<0.05).Conclusion: Ginkgo leaf tablet has some liver protective and anti-liver fibrosis benefits.     

Effects of Da Ding Feng Zhu Decoction in 30 Cases of Liver Fibrosis

To study the clinical effects of Da Ding Feng Zhu (大定风珠) Decoction on liver fibrosis. 56 patients withliver fibrosis due to chronic hepatitis B were randomly divided into a treatment group (30 cases treatedwith Da Ding Feng Zhu Decoction) and a control group (26 cases treated with colchicine). The serumlevels of hyaluronic acid (HA), procollagen Ⅲ (PC-Ⅲ), Ⅳ collagen (Ⅳ-C) and Laminin (LN) of thepatients were determined, compared and analyzed before treatment and after 3-month treatment in the twogroups. The results showed that in the treatment group, the levels of HA, PC-Ⅲ, Ⅳ-C and LN after3-month treatment were significantly lowered as compared to that before treatment (P＜0.01). In thecontrol group, only the HA level was obviously lowered (P＜0.05). There was an significant difference(P＜0.05) in PC-Ⅲ and Ⅳ-C and a very significant difference (P＜0.01) in HA after treatment between thetwo groups. It is therefore concluded that Da Ding Feng Zhu Decoction can lower serum indexes of liverfibrosis.     

Effects of Da Ding Feng Zhu Decoction in 30 Cases of Liver Fibrosis

To study the clinical effects of Da Ding Feng Zhu (大定风珠) Decoction on liver fibrosis. 56 patients withliver fibrosis due to chronic hepatitis B were randomly divided into a treatment group (30 cases treatedwith Da Ding Feng Zhu Decoction) and a control group (26 cases treated with colchicine). The serumlevels of hyaluronic acid (HA), procollagen Ⅲ (PC-Ⅲ), Ⅳ collagen (Ⅳ-C) and Laminin (LN) of thepatients were determined, compared and analyzed before treatment and after 3-month treatment in the twogroups. The results showed that in the treatment group, the levels of HA, PC-Ⅲ, Ⅳ-C and LN after3-month treatment were significantly lowered as compared to that before treatment (P<0.01). In thecontrol group, only the HA level was obviously lowered (P<0.05). There was an significant difference(P<0.05) in PC-Ⅲ and Ⅳ-C and a very significant difference (P<0.01) in HA after treatment between thetwo groups. It is therefore concluded that Da Ding Feng Zhu Decoction can lower serum indexes of liverfibrosis.     

血清TGF-β1表达水平与慢性乙型肝炎患者肝纤维化的相关性研究

目的 探讨慢性乙型肝炎患者血清转化生长因子-β1(TGF-β1)与血清肝纤维化指标的关系,评价其对早期肝纤维化诊断的临床价值.方法 分别检测38例慢性乙型肝炎患者和10名健康者(对照组)血清中TGF-β1水平和透明质酸(HA)、层粘蛋白(LN)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PC Ⅲ)水平.患者均行肝组织穿刺活检,标本进行常规HE染色和胶原纤维染色.结果 慢性乙型肝炎中、重度患者血清TGF-β1水平［(202±78)mg/L,(401±63)mg/L］显著高于对照组［(75±34)mg/L,P＜0.01］,HA、LN、IVC、PC Ⅲ水平随肝纤维化进展而呈逐渐升高.各组血清HA、LN、IVC、PC Ⅲ均与血浆TGF-β1呈明显正相关(P＜0.01).结论 慢性乙型肝炎患者血清TGF-β1水平与肝纤维化指标呈正相关,其对早期诊断出肝硬化具有重要意义. Abstract： Objective To study the relationship between serum level of TGF-β1 and hepatic fibrosis parameters in patients with chronic hepatitis B. Methods Serum TGF-β1 and hyalauronic acid(HA), laminin (LN), type Ⅳ collagen(Ⅳ-C) and type Ⅲ procollagen (PC Ⅲ) were detected by ELISA in 38 patients with chronic hepatitis B (CHB). Ten healthy persons served as controls. Liver puncture was performed in all patients with CHB. Results Serum TGF-β1 levels in moderate, severe CHB ［(202±78)mg/L,(401±63)mg/L］ were much higher than those of the control group ［(75±34)mg/L,P＜0.01］ and increased successively. TGF-β1 was correlated positively with serum levels of HA,LN,Ⅳ-C and PC Ⅲ (P＜0.01). Serum TGF-β1, PCⅢ, LN, Ⅳ-C and HA increased successively (P＜0.01) with aggravation of hepatic fibrosis. Conclusions Serum TGF-β1 levels of patients with CHB are consistent with serum indexes of hepatic fibrosis. It can help to judge the degree of hepatic tissue fibrosis.     

Relationship between liver fibrosis criteria and syndrome-type of TCM in patients with non-alcoholic fatty liver

To explore the relationship between the liver fibrosis criteria and TCM Syndrome type in patients suffering from non-alcoholic fatty liver. Methods: Seventy-nine patients with non-alcoholic fatty liver diagnosed by B ultrasonography were classified by TCM Syndrome Differentiation and their liver fibrosis criteria was determined and compared with those of the healthy subjects as control. Results: Levels of procollagen Ⅲ (PCⅢ), hyaluronic acid (HA), collagen Ⅳ(CⅣ) and laminin (LN) in the fatty liver group were significantly higher than those in the control group (P＜0.05, P＜0.01). In respect to the TCM Syndrome-types, PCⅢ, CⅣ and LN in patients of Phlegm-stasis combined type were significantly higher than those in patients of Spleen deficiency-Phlegm dampness Syndrome-type and Damp-Heat Syndrome-type (P＜0.05, P＜0.01), while HA in different groups was insignificantly different (P＞0.05). Conclusion: There was trend of liver fibrosis in fatty liver patients. It was indicated that the Phlegm-stasis combined Syndrome-type possibly was the main TCM pathologic factor of the increasing of fibrosis criteria for non-alcoholic fatty liver.     

FEASIBILITY OF DIAGNOSING AND STAGING LIVER FIBROSIS WITH DIFFUSION WEIGHTED IMAGING

Objective To assess the clinical feasibility of diagnosing and staging liver fibrosis by apparent diffusion coefficient （ADC）.
Methods Totally, 43 patients （mean age 29.3 years） with chronic hepatitis by liver biopsy and 7 healthy controls （mean age 39.9 years） underwent liver diffusion weighted imaging （DWI） with four b values： 0, 200, 500, and 1000 s/mm^2 respectively. The liver fibrosis was staged according to Ishak fibrosis stage. The ADC value of liver fibrosis patients and healthy controls was compared. The correlation of ADC value and liver fibrosis staging was analyzed.
Result The histological staging showed 8 stage 1 patients, 10 stage 2 patients, 6 stage 3 patients, 9 stage 4 patients, 8 stage 5 patients and 2 stage 6 patients. The mean ADC value of liver fibrosis patients was significantly lower than that of healthy controls except for stage 1 group （P 〈 0.05）. There was a negative correlation between liver fibrosis staging and ADC value （r = -0.697 with b=500 s/mm^2, P 〈 0.01）. Receiver operating characteristic （ROC） curve of ADC value of advanced liver fibrosis （Ishak stage F3 and higher） showed that area under curve = 0.913, 0.825, and 0.794 with b = 500, 1000, and 200 s/mm^2, respectively （95% confidence interval： 83.6%-99.0%, 70.7%-94.3%, 66.5%- 92.4%; P 〈 0.05）. When b value was 500 s/mm^2, the sensitivity （84%） and specificity （80%） of DWI for diagnosis of advanced liver fibrosis were the highest.
Conclusion DWI is proved to be a useful clinical tool in the quantitative evaluation of liver fibrosis and in the prediction of the process of liver fibrosis with the recommendable b value （500 s/mm^2）.     

磁共振弥散加权成像评价肝纤维化的临床病理对照研究

Objective To evaluate the clinical practical value of apparent diffusion coefficient (ADC) measurements based on diffusion-weighted MR imaging (DWI) for quantification of liver fibrosis and inflammation for hepatitis viral infection.Methods Diffusion-weighted MRI with parallel imaging was prospectively performed on 85 patients with chronic hepatitis and on 22 healthy volunteers within a single breath-hold using a single-shot spin-echo echo-planar sequence at b values of 100, 300, 500,800 and 1000 s/mm2 respectively. ADC values of liver were measured with five different b values. The inflammation grades and fibrosis stages were evaluated histologically by biopsy. One-way analysis of variance and Spearman' s rank correlation test were used for statistical analysis. Receiver operating characteristics analysis was used to assess the performance of ADC in predicting the presence of stage ≥2 and stage ≥3 hepatic fibrosis, and grade ≥1 hepatic inflammation. Results There was moderate negative correlation between hepatic ADC values and fibrosis stage. And the best correlation was obtained for a b value of 800 s/mm2 (r = - 0. 697, P=0.000). At all b values there was a significant decrease in hepatic ADC in patients with stage ≤1versus stage ≥2 fibrosis and stage ≤2 versus stage ≥3 fibrosis (P <0. 05). Hepatic ADC was a significant predictor of stage ≥2 and ≥3 fibrosis. The areas under the curve were 0. 909 vs 0. 917, sensitivity 76. 6% vs 80. 0% and specificity 88. 3% vs 91.5% (ADC with a b value of 800 s/mm2, 1.26 × 10<'3> mm2/s or less and 1.19 × 10-3 mm2/s or less). There was weak to moderate negative correlation between ADCs and inflammation grade. Hepatic ADC was a significant predictor of grade ≥1 inflammation with an area under the curve of 0. 781, sensitivity of 60. 0% and specificity of 86. 4% (ADC with a b value of 500 s/mm2, 1.54 × 10-3 mm2/s or less). Conclusion The D WI measurement of hepatic ADC can be used to quantify liver fibrosis and inflammation. It will be a new approach for early diagnosis and therapeutic follow-up of hepatic fibrosis.     

磁共振弥散加权成像评价肝纤维化的临床病理对照研究

Objective To evaluate the clinical practical value of apparent diffusion coefficient (ADC) measurements based on diffusion-weighted MR imaging (DWI) for quantification of liver fibrosis and inflammation for hepatitis viral infection.Methods Diffusion-weighted MRI with parallel imaging was prospectively performed on 85 patients with chronic hepatitis and on 22 healthy volunteers within a single breath-hold using a single-shot spin-echo echo-planar sequence at b values of 100, 300, 500,800 and 1000 s/mm2 respectively. ADC values of liver were measured with five different b values. The inflammation grades and fibrosis stages were evaluated histologically by biopsy. One-way analysis of variance and Spearman' s rank correlation test were used for statistical analysis. Receiver operating characteristics analysis was used to assess the performance of ADC in predicting the presence of stage ≥2 and stage ≥3 hepatic fibrosis, and grade ≥1 hepatic inflammation. Results There was moderate negative correlation between hepatic ADC values and fibrosis stage. And the best correlation was obtained for a b value of 800 s/mm2 (r = - 0. 697, P=0.000). At all b values there was a significant decrease in hepatic ADC in patients with stage ≤1versus stage ≥2 fibrosis and stage ≤2 versus stage ≥3 fibrosis (P <0. 05). Hepatic ADC was a significant predictor of stage ≥2 and ≥3 fibrosis. The areas under the curve were 0. 909 vs 0. 917, sensitivity 76. 6% vs 80. 0% and specificity 88. 3% vs 91.5% (ADC with a b value of 800 s/mm2, 1.26 × 10<'3> mm2/s or less and 1.19 × 10-3 mm2/s or less). There was weak to moderate negative correlation between ADCs and inflammation grade. Hepatic ADC was a significant predictor of grade ≥1 inflammation with an area under the curve of 0. 781, sensitivity of 60. 0% and specificity of 86. 4% (ADC with a b value of 500 s/mm2, 1.54 × 10-3 mm2/s or less). Conclusion The D WI measurement of hepatic ADC can be used to quantify liver fibrosis and inflammation. It will be a new approach for early diagnosis and therapeutic follow-up of hepatic fibrosis.     

磁共振弥散加权成像评价肝纤维化的临床病理对照研究

Objective To evaluate the clinical practical value of apparent diffusion coefficient (ADC) measurements based on diffusion-weighted MR imaging (DWI) for quantification of liver fibrosis and inflammation for hepatitis viral infection.Methods Diffusion-weighted MRI with parallel imaging was prospectively performed on 85 patients with chronic hepatitis and on 22 healthy volunteers within a single breath-hold using a single-shot spin-echo echo-planar sequence at b values of 100, 300, 500,800 and 1000 s/mm2 respectively. ADC values of liver were measured with five different b values. The inflammation grades and fibrosis stages were evaluated histologically by biopsy. One-way analysis of variance and Spearman' s rank correlation test were used for statistical analysis. Receiver operating characteristics analysis was used to assess the performance of ADC in predicting the presence of stage ≥2 and stage ≥3 hepatic fibrosis, and grade ≥1 hepatic inflammation. Results There was moderate negative correlation between hepatic ADC values and fibrosis stage. And the best correlation was obtained for a b value of 800 s/mm2 (r = - 0. 697, P=0.000). At all b values there was a significant decrease in hepatic ADC in patients with stage ≤1versus stage ≥2 fibrosis and stage ≤2 versus stage ≥3 fibrosis (P <0. 05). Hepatic ADC was a significant predictor of stage ≥2 and ≥3 fibrosis. The areas under the curve were 0. 909 vs 0. 917, sensitivity 76. 6% vs 80. 0% and specificity 88. 3% vs 91.5% (ADC with a b value of 800 s/mm2, 1.26 × 10<'3> mm2/s or less and 1.19 × 10-3 mm2/s or less). There was weak to moderate negative correlation between ADCs and inflammation grade. Hepatic ADC was a significant predictor of grade ≥1 inflammation with an area under the curve of 0. 781, sensitivity of 60. 0% and specificity of 86. 4% (ADC with a b value of 500 s/mm2, 1.54 × 10-3 mm2/s or less). Conclusion The D WI measurement of hepatic ADC can be used to quantify liver fibrosis and inflammation. It will be a new approach for early diagnosis and therapeutic follow-up of hepatic fibrosis.     

慢性乙肝患者血浆同型半胱氨酸测定及其与肝纤维化程度的相关性研究

目的探究慢性乙肝患者血浆同型半胱氨酸(Hcy)测定及其与肝纤维化程度的相关性。方法选取2017年1月-2019年1月于我院接受治疗的60例慢性乙肝患者(观察组)及同期接受体检的30例自愿者(健康对照组)为研究对象。观察组患者根据肝纤维化程度分为S0期-S4期,分别比较观察组、健康对照组及观察组不同肝纤维化程度受试者血浆Hcy及肝纤维化指标[透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)]水平差异;经Spearman等级相关分析慢性乙肝患者肝纤维化程度与血浆Hcy水平、肝纤维化指标(HA、LN、PCⅢ、Ⅳ-C)的相关性。结果观察组患者血浆Hcy、HA、LN、PCⅢ、Ⅳ-C水平均明显高于健康对照组(P均<0.05)。观察组不同肝纤维化程度患者分级相邻组间比较有统计学意义(P<0.05)。慢性乙肝患者血浆Hcy水平及HA、LN、PCⅢ、Ⅳ-C水平与肝纤维化程度呈正相关性(r=0.701,0.712,0.705,0.708,0.698,P均<0.05)。结论慢性乙肝患者体内血浆Hcy水平明显高于健康对照组,且随着肝纤维化程度加重,其血浆Hcy水平与肝纤维化指标均显著上升,与肝纤维化程度呈现正相关。     

血清总胆红素与肝硬化病情预后及肝纤维化的关系

目的：研究肝硬化患者血清总胆红素（SB）变化与Child-pugh及肝纤维化的关系。方法：检测98例肝硬化患者的血清SB，白蛋白、凝血酶原时间、透明质酸（HA）、Ⅲ型前胶原（PCⅢ）、Ⅳ胶原（Ⅳ-C）及层黏蛋白（LN）；计算Child-pugh记分。结果：随着Child-pugh分级的递增，血清PCⅢ、Ⅳ-C、HA及SB水平进级升高，C级与A级比较均有显著性差异（P〈0．01）。血清SB与PCⅢ、Ⅳ-C、LN及HA呈显著正相关（P〈0．05）。结论：血清SB升高与肝纤维化及Child-pugh分级有密切关系。     

肝硬化血清总胆汁酸检测的临床意义

①目的 探讨肝硬化患者血清总胆汁酸（TBA）与肝纤维化标志物及其与Child-pugh分级的关系。②方法检测56例肝硬化患者的血清TIH、胆红素、凝血酶原时间、透明质酸（HA）、Ⅲ型前肢原（PCⅢ）、Ⅳ胶原（Ⅳ-C）及层黏蛋白（LN）。③结果随着Child-pugh分级的增加．血清HA、PCⅢ、Ⅳ-C、LN及TBA水平逐步增高，C级与A级比较均有显著性差异（P〈0．01）。血清TBA与PCⅢ、Ⅳ-C及HA呈显著正相关（P〈0．005；P〈0．05；P〈0、0005），但与LN相关不显著（P〉0．05）。④结论血清TBA升高与肝纤维化及Chihl-pugh分级有密切关系，联合检测TBA与肝纤维化标志物，对判断肝硬化患者病情及预后有重要参考意义。     

柔肝合剂与鳖甲煎丸抗肝纤维化疗效比较

目的　观察柔肝合剂抗慢性乙型肝炎肝纤维化的作用 ,寻找抗肝纤维化的简单、价廉的有效方剂。方法　选择慢性乙型肝炎肝纤维化患者 12 0例 ,随机分为柔肝合剂治疗组 6 4例和鳖甲煎丸对照组 5 6例 ,进行疗程相同的对照治疗。观察项目为血清透明质酸 (HA)、Ⅲ型前胶原 (PCⅢ )、层黏蛋白 (LN)、Ⅳ型胶原 (Ⅳ -C)。结果　治疗组与对照组治疗后HA、PCⅢ、LN、Ⅳ -C均有明显下降 ,而 2组间比较则无显著差异 (P >0 .0 5 )。结论　柔肝合剂的抗肝纤维化作用与鳖甲煎丸疗效相近 ,是一种抗肝纤维化的简单、价廉的有效方剂     

恩替卡韦联合复方丹参滴丸治疗慢性乙型肝炎肝纤维化的临床研究

目的：观察恩替卡韦联合复方丹参滴丸治疗慢性乙型肝炎肝纤维化的临床疗效。方法：60例乙肝肝纤维化患者,随机分为两组,联合治疗组给予复方丹参滴丸和恩替卡韦治疗,对照组只给予恩替卡韦治疗,疗程均为6个月。观察治疗后两组HBV-DNA及肝纤维化指标（HA、LN、PCⅢ、CⅣ）变化情况。结果：治疗后两组血清HBV—DNA、肝纤维化指标较治疗前均明显下降,治疗组肝纤维化指标明显低于对照组（P〈0．01）。结论：恩替卡韦联合复方丹参滴丸即能有效抑制乙肝病毒复制,同时可以明显改善慢性乙型肝炎肝纤维化指标。     

肝纤维化诊断中肝穿病理分期及非创伤性指标相关性研究

目的评价肝纤维化非创伤性指标对诊断肝纤维化的应用价值。方法测定122例慢性肝炎病人的血清肝纤维化指标．肝脏B超检查,并对肝活检组织学检查进行比较,以建立非创伤性指标对肝纤维化的诊断优势。结果超声检查对门脉高压性肝硬化的诊断价值已肯定,但对轻、中度肝纤维化患者超声检查的指标的变化还不很显著,随着肝纤维化分期的上升,透明质酸（HA）、Ⅲ型胶原（PCIU）、Ⅳ型胶原（cIV）、层黏连蛋白（LN）的水平也随之增高,其水平与肝纤维化分期呈正相关。结论血清肝纤维化相关标志结合B超检查门静脉主干内径、脾长径及脾静脉内径对肝纤维化有良好的诊断价值,联合检测结果与肝纤维化病理分级有一定的相关性。     

慢性病毒性肝炎门脉血流速度、血流量与血清纤维化指标及肝组织病理改变的关系

目的：阐明慢性肝炎纤维化程度与门脉血流动力学的相关性。方法：测定71例慢性乙型肝炎患者门脉因流速度（portal blood velocity,PBFVe)，门脉血流量（portal blood,flow,PBFVo)和血清学纤维化指标并观察肝组织的病理改变情况。结果（1）PBFVe与肝比价经分明关系,与血清透明质酸（HA），Ⅳ型胶原（Ⅳ－C）水平呈负相关，且纤维化程度严重者PBFVo明显低于肝纤维化程度轻者，当肝纤维化分期为S4时S1期减慢了29．82％（P＜0．01）；（2）而PBFVo与肝比价经分期无关，受肝内炎症活动的影响，与血清Ⅲ型前胶原（PC0Ⅲ）水平呈负相关。结论：在慢性肝炎肝纤维化发展过程中，PBFVe与HA，Ⅳ－C相结合能够较好地反映肝比价经程度，PBFVo与血清PCⅢ相结合对判定肝内炎症活动度有意义。     

扶正化瘀胶囊干预慢性乙型肝炎肝纤维化作用的多中心临床研究

目的　研究扶正化瘀胶囊治疗慢性乙型肝炎肝纤维化的临床疗效及其安全性。方法　多中心、随机、双盲、平行对照的方法 ,入选年龄 18～ 65岁的慢性乙型肝炎肝纤维化患者。试验药 (扶正化瘀胶囊 )和对照药 (和络舒肝胶囊 ) ,均为每次 5粒 ,3次 /d口服 ;疗程 2 4周。疗程结束后进行 12周的随访。观测指标 :(1)于治疗第 0、2 4周观察肝组织病理学、HBV标志物 ,第 0、12、2 4周检测肝纤维化血清指标 (HA、LN、P Ⅲ P、Ⅳ C)、B超肝脾检查 ,第 0、6、12、18、2 4周观察肝功能 (随访期评价肝功能、血清肝纤维化指标 )。 (2 )安全性指标 :治疗前、后检测血、尿常规 ,肾功能 ,心电图。结果　 (1)受试者入组情况及人口学资料 :试验组 110例 ,对照组 10 6例 ,两组病例人口学特征、生命体征、病程、药物过敏史、既往治疗史、肝功能、纤维化血清学指标、肝组织病理学 (试验组 99例 ,对照组 96例 )、HBV标志物、肾功能等各项指标比较 ,无显著差异。 (2 )肝组织病理学 :治疗前后作活检肝组织学观察 93例 ,试验组 50例和对照组 43例治疗前纤维化分期 (S)均值分别为 2 .3 3和 2 .11。试验组治疗后S均值为 1.80 ,较治疗前显著下降。对照组治疗后S均值为 2 .14 ,与治疗前比较无显著改善。试验组活检肝组织纤维化分期判断     

探讨慢性乙型肝炎患者血清肝纤4项指标与血小板的相关关系

目的探讨慢性乙型肝炎患者血清肝纤维化4项指标与血小板数量（PLT）的相关性。方法对慢性乙型肝炎患者PLT测定的同时,采用r-放免计数仪测定血清透明质酸（HA）、层粘连蛋白（LN）、Ⅲ型胶原（PCⅢ）、Ⅳ型胶原（CⅣ）4个肝纤维化指标,然后应用SPSS 13.0统计分析软件对所得数据进行相关性分析。结果在慢性乙型肝炎中,随着肝炎严重程度的增大,HA的值明显增大（P〈0.05）,LN、PCⅢ、CⅣ变化不明显;随着PLT值的增大,肝纤维化4项指标中除了LN,HA、PCⅢ、CⅣ3项的血清水平均显著下降（P〈0.05）。结论 HA与PLT的相关性最好,是反映肝纤维化最好的指标之一,综合考虑HA等相关肝纤及PLT是诊断肝纤维化有效的血清学方法。     

肝复乐胶囊对慢性乙型肝炎患者肝功能及肝纤维化指标的影响

目的探讨肝复乐胶囊对慢性乙型肝炎患者肝功能和肝纤维化指标的影响。方法将慢性乙型肝炎患者98例随机分为观察组和对照组,每组各49例,治疗前后检测肝功能,用放射免疫法检测血清纤维化指标Ⅲ型前胶原（PCIII）、IV型胶原（CIV）、透明质酸（HA）、层黏蛋白（LN）。结果观察组治疗后肝功能明显好转,血清PCI．II、CIV、HA、LN水平较治疗前及对照组治疗后均明显降低（P〈0．05）。结论肝复乐胶囊治疗慢性乙型肝炎肝纤维化有很好的效果。