血清学六指标联合检测对慢性肝病的诊断价值

目的 寻找反映慢性肝病肝纤维化进展程度敏感可靠的血清学诊断指标。方法 对184例住院肝病患联合检测血清Ⅲ型前胶原（PCⅢ）、透明质酸（HA）、层粘蛋白（LN）、甲胎蛋白（AFP）、铁蛋白（SF）、胚抗原（CEA）。并与8例肝组织学检查及30例无肝病史及肝功能异常的常规体格检查进行对照研究。结果 六项指标阳性率在慢性肝炎轻度（CHI）、急性肝炎（AVH）、慢性肝炎中度（CHⅡ）、慢性肝炎重度（CHⅢ）、肝硬变（LC）、肝细胞癌（HCC）及慢性重型肝炎（CHG）各组间，依次递增，与各级肝病中纤维化程度及临床病情的轻重有良好的相关性。结论 联合检测血清PCⅢ、HA、LN、AFP、SF、CEA可明显提高慢性肝病诊断的准确性与可靠性，作为判断肝纤维化、肝硬化程度及有无伴发肝癌的良好指标，重复性好，无创伤，便于掌握病变进展情况。

Diagnostic value of co-detection of six serous markers in patients with chronic hepatic diseases

Objective To sutdy sensitive and reliable serum markers of liver fibrosis in patients with chronic hepatic diseases for early clinical diagnosis．Methods We carried out co-detection of serum PCⅢ，HA，LN，AFP，SF，CEA in 184 cases compared with liver biopsy samples of 8 cases and the routine examination of 30 cases without chronic hepatic disease and abnormal liver function．Results The positive rates of the six markers increased in order of precedence in the chromic hepatitis（light）（CHⅠ），the acute hepatitis（AVH），chronic hepatitis（middle）（CHⅡ），chronic hepatitis（heavy）（CHⅢ），cirrhosis of liver（LC），hepatocellular carcinoma（HCC）and chronic hepatitis（grave）（CHG），which were corelated closely to the degree of hepatic fibrosis and the clinical condition．Conclusion The co-detection of six markers can improve the accuracy and reliability of clinical diagnosis in chronic hepatic diseases，and can be considered to be good markers for judgement of the fibrosis of liver and hepatocarcinoma．