肝炎患者血清肝纤维化指标及PAPP指数检测在肝纤维化诊断中的价值

目的探讨由血清中透明质酸（HA）Ⅲ型前胶原氨基端肽（PⅢNP）、Ⅳ型胶原（C-Ⅳ）及层粘连蛋白（LN）组成的肝纤四项与由血小板计数（PT）、血清谷丙转氨酶（ALT）、凝血酶原时间（PT）前白蛋白（PA）组成的PAPP指数在肝纤维化诊断中的应用价值。方法选取128例处于不同炎症进展期的病毒性肝炎患者（包括60例肝穿刺患者）的标本及60例正常对照组的标本,检测血清中的HA、PⅢNP、C-Ⅳ、LN、ALT、PA、PT、PLT。结果肝纤四项与PAPP指数在肝炎各组及肝纤维化组不同病理分期的差异均有统计学意义（P＆lt;0.05）。结论肝纤四项及PAPP指数的联合检测有助于肝纤维化的临床诊断和对抗纤维化的疗效监测。

Value of indexes of serum hepatic fibrosis and PAPP of patients with hepatitis in the diagnosis of hepatic fibrosis

Objective To explore the value of the four indicators composed of the serum hyaluronie acid （HA） Ⅲ, proeollagen N-terminal peptide （P Ⅲ NP）, collagen type Ⅳ（C- IV） and laminin （LN）, and PAPP index consisting of platelet count （ PT ）, serum alanine aminotransfemse （ ALT）, prothrombin time （PT） and pre- albumin （PA） in the diagnosis of hepatic fibrosis. Methods Serum markers were studied in 108 eases of patients with viral hepatitis of different developmental periods of inflammation, including 60 patients who have undergone ilv- er puncture diagnosis and 60 cases from normal control group with a view to the determination of the serum HA, P Ⅲ NP, C - Ⅳ, LN , ALT, PA, PT and PLT. Results The differences of the four indicators of hepatic fibrosis and PAPP index among their respective groups were of statistical significance （ P 〈 0.05 ）. Conclusion The eo - detection of four indicators of hepatic fibrosis and PAPP index contributes to the clinical diagnosis of hepatic fibrosis and the monitoring of thempeutie effect of antifibrotic drugs.