血清透明质酸预测肝纤维化的再评价

目的 分析影响慢性肝炎患者血清透明质酸(HA)水平的因素,进一步探讨血清HA预测肝纤维化的价值.方法 慢性肝炎81例,诊断参照2000年全国病毒性肝炎及肝病学术会议修订的标准;血清HA采用放射免疫法检测,肝穿刺活检标本进行分级和分期.统计分析采用SPSS 11.5软件,采用有交互作用的双因素协方差分析,考察影响血清HA水平的主要因素.结果 年龄与病理分级和分期之间无显著相关性(rs=-0.006,P=0.956和rs=0.124,P=0.270),年龄与血清HA水平之间呈显著正相关(r=0.413,P=0.000);病理分级与分期之间呈显著正相关(rs=0.633,P=0.000);病理分级和分期与血清HA水平之间呈显著正相关(rs=0.290,P=0.009和rs=0.543,P=0.000);单因素方差分析结果显示,不同病理分级和分期患者血清HA水平之间均存在显著性差异(F=3.871,P=0.025和F=8.476,P=0.000),双因素协方差分析结果显示,影响血清HA水平的主要因素依次为年龄和病理分期,其偏Eta平方值分别为0.198和0.103.结论 血清HA水平可预测慢性肝炎肝纤维化,但血清HA受年龄因素的影响.

Reappraisal of serum hyaluronic acid levels for predicting liver fibrosis in patients with chronic hepatitis

Objective To analyze the factors influencing serum hyaluronic acid (HA) level in patients with chronic hepatitis, and to reappraise the validity of serum HA level for predicting liver fibrosis. Methods 81 patients with chronic hepatitis were enrolled. Serum HA was determined by RIA, and pathological grading and staging of the liver were judged according to the National criteria 2000 revision. SPSS 11.5 software was used for statistical analyses. The factors influencing serum HA level were analyzed by double variate analysis of covariance with interaction. Results Both the pathological grading and staging of the liver were not correlated significantly with age (r_s=-0.006, P=0.956 and r_s=0.124, P=0.270), and the serum HA level was correlated significantly with age (r=0.413, P=0.000); Both the pathological grading and staging of the liver were correlated significantly with the serum HA level (r_s=0.290, P=0.009 and r_s=0.543, P=0.000). There were significant difference in serum HA levels among different pathological grading and staging (F=3.871, P=0.025 and F=8.476, P=0.000) according to the analysis of variance; the main factors influencing serum HA level were age and pathological staging, and the partial Eta squared were 0.198 and 0.103 respectively. Conclusions Serum HA could be used as an index for predicting liver fibrosis in patients with chronic hepatitis, but the influence of the patients' age should be considered.