透明质酸、层粘连蛋白、Ⅳ型胶原的检测及意义

目的：探讨慢性乙肝患者血清中肝纤维化3项指标，透明质酸(HA)、层粘连蛋白(LM)、Ⅳ型胶原(Ⅳ．C)的检测及意义。方法：放射免疫法。结果：231例患肝病者在不同时期肝纤维检测的结果不同。结论：联合检测LM、HA、Ⅳ．C是反映肝纤维化的良好指标。     

Ⅲ型前胶原、Ⅳ型胶原、透明质酸及层粘连蛋白在诊断肝纤维化中的意义

目的　探讨血清Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)、透明质酸 (HA)及层粘连蛋白 (LN)的测定在诊断肝纤维化中的意义。方法　用放射免疫法检测 263例慢性乙型肝炎、67例急性乙型肝炎、27例肝硬化及 20例健康人血清PCⅢ、CⅣ、HA及LN,并进行了统计学分析。结果　中度、重度慢性乙型肝炎及肝硬化的 4项指标定量结果均高于对照组、急性乙型肝炎及轻度慢性乙型肝炎(P<0. 001)。4项指标联合检测显示,重度慢性乙型肝炎及肝硬化的阳性率 (84. 3%与 88. 9% )显著高于其他组别。结论　联合检测血清PCⅢ、CⅣ、HA及LN水平对诊断肝纤维化有较大意义。     

血清透明质酸、Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白水平与肝纤维化的关系

为了研究无创伤性、可靠的肝纤维化诊断指标.我们从1998年开始对慢性肝病(包括肝硬化患者)血清Ⅲ型前胶原(PCⅢ)、透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(VC)进行了检测,现将结果报告如下.     

癌症患者血清透明质酸、Ⅳ型胶原及层粘连蛋白水平变化及其临床意义

目的探讨癌症患者血清透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)及层粘连蛋白(LN)的水平变化及与恶性肿瘤病变的关系。方法采用放射免疫法测定303例癌症患者、39例一般疾病患者及33例健康志愿者血清HA、Ⅳ-C和LN水平。结果癌症患者血清HA、Ⅳ-C和LN水平显著增高,较正常对照组、一般疾病组差异有统计学意义(P<0.05),一般疾病组与正常对照组各指标之间差异无统计学意义(P>0.05)。结论血清HA、Ⅳ-C和LN水平变化对癌症患者诊断、病情转归及预后判断有参考价值。     

血清透明质酸、Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白水平与肝纤维化的关系

为了研究无创伤性、可靠的肝纤维化诊断指标,我们从1998年开始对慢性肝病(包括肝硬化患者)血清Ⅲ型前胶原(PCⅢ)、透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(VC)进行了检测,现将结果报告如下。     

血清透明质酸、层粘蛋白、Ⅳ型胶原水平与肝纤维化的关系

目前认为肝纤维化是肝硬化的必经阶段 ,及时诊断肝纤维化是防治肝硬化的关键。为进一步了解血清透明质酸 (HA)、层粘蛋白 (L N)、 型胶原 ( - C)水平与肝组织纤维化程度的关系 ,我们采用放射免疫法测定 5 5例慢性乙型肝炎 (CHB)患者血清 HA、L N、 - C含量 ,与肝组织病理分级、分期比较分析 ,现将结果报道如下。1　材料与方法1.1　对象　 1999年 6月至 2 0 0 0年 6月本院收治的 CHB患者 ,共 5 5例 ,其中男 46例 ,女 9例 ,年龄 15～ 45岁 ,平均 (31.3±6 .7)岁。按 1995年第五次全国传染病与寄生虫病学术会议制订的病毒性肝炎防治方案…     

IV—胶原,透明质酸,层粘连蛋白对肝纤维化诊断的临床价值

近年来随着肝纤维比研究的逐步深入,认为肝纤维化的实质是肝内胶原的异常沉积.目前肝纤维化的血清学诊断也有了很大进展,我们通过对血清细胞外基质成份IV-胶原(IV Collagen,IV-C),透明质酸(Hyalunonate Acid HA),层粘连蛋白(Laminim LN)水平变化的研究,探讨其临床应用价值.     

肝病患者血清肝纤维化标志物检测及意义

应用放射免疫分析法地肝病患者血清透明质酸、层粘连蛋白和Ⅳ型胶原水平进行了测定。结果：肝病患者血清透明质酸、层粘连蛋白和Ⅳ型胶原水平显著高于健康人（Ｐ〈０．００１），提示三种标志联合检测对慢性肝病的肝纤维化早期发现和肝硬化的诊断有重要价值。     

肝纤维化大鼠血清透明质酸、Ⅲ型前胶原、层粘连蛋白及羟脯氨酸水平与丹参、桃仁复方制剂的干预

目的:观察丹参、桃仁复方制剂对肝纤维化大鼠血清透明质酸、Ⅲ型前胶原、层粘连蛋白及羟脯氨酸水平的影响,并与复方鳖甲软肝片进行阳性药物对照。方法:实验于2004-04/12在成都中医药大学药理实验室完成。①70只SD大鼠随机取10只为空白对照组,其余60只大鼠皮下注射CCl4,同时给予高脂饲料和体积分数为0.2的乙醇喂养6周建立肝纤维化大鼠模型,造模成功的50只大鼠按性别、体质量随机分为模型组,丹参和桃仁复方制剂高、中、低剂量组,复方鳖甲软肝片组5组,每组10只。②空白对照组和模型组灌胃给予蒸馏水0.1mL/kg,丹参和桃仁复方制剂高、中、低剂量组灌胃给予6,3,1.5g/kg丹参和桃仁复方制剂(主要成分为丹参、桃仁、白芍、黄芪、柴胡、汉防己、冬虫夏草等),复方鳖甲软肝片组灌胃给予1g/kg复方鳖甲软肝片,1次/d,连续4周。③末次给药后24h,髂外静脉取血,测定血清透明质酸、Ⅲ型前胶原、层粘连蛋白及羟脯氨酸水平。结果:60只大鼠进入结果分析。①透明质酸质量浓度:模型组比空白对照组增高了256.72%,丹参、桃仁复方制剂高剂量组比模型组降低39.46%(P<0.05)。②层粘连蛋白质量浓度:模型组比空白对照组增高了100.73%,丹参、桃仁复方制剂高、低剂量组比模型组降低18.29%,21.99%(P<0.05)。③羟脯氨酸浓度:模型组比空白对照组增高了315.75%,丹参、桃仁复方制剂高、中剂量组比模型组降低34.26%,46.65%(P均<0.01)。④复方鳖甲软肝片组大鼠血清Ⅲ型前胶原、层粘连蛋白和羟脯氨酸浓度比模型组分别降低20.99%,27.50%,22.91%。结论:丹参、桃仁复方制剂能降低CCl4复合因素致纤维化模型大鼠血清透明质酸、层粘连蛋白和羟脯氨酸水平,其效果优于复方鳖甲软肝片。     

血清透明质酸、Ⅲ型前胶原、Ⅳ型胶原及层粘蛋白水平与实验性肝纤维化的关系

目的：评价血清透明质酸（HA）、Ⅲ型前胶原（PCⅢ）、Ⅳ型胶原（CIV）及层粘蛋白（LN）水平与实验性肝纤维化的关系。方法：采用半定量计分系统（SSS）中炎症活动度及纤维化程度计分方案对温阳中药肝之福预防及治疗肝纤维化大鼠实验的病理组织共73份标本进行半定量计分,同时检测血清HA、PCⅢ、CⅣ及LN水平,进行Pearson相关性分析。结果：四项血清肝纤维化指标不论与肝脏炎症活动度还是纤维化程度均呈正相关（P〈0．01）。结论：血清HA、PCⅢ、CⅣ及LN水平可在一定程度上反映肝组织的炎症和纤维化程度,联合检测价值较高。     

肝硬化患者血清LN、PLD、Ⅳ.C、HA、CG结果分析

目的：探讨血清LN、PLD、Ⅳ．C、HA、CG在诊断肝硬化疾病上的价值，为放免检测在选择这些标志物组成系列方面提供依据，给临床医生正确应用这些指标提供参考。方法：应用放射免疫法和比色法测定了80例肝硬化患者外周血中的以上五种标志物，用统计学方法进行结果分析。结果：五种标志物对肝硬化的阳性率依次是HA95％、CG95％、ⅣC80％、LN68％、PLD60％，而且HA、CG以高水平的升高为主，Ⅳ．C、LN、PLD以中低水平分布为主。结论：在肝硬化诊断上选择这些项目的顺序是HA、CG、N．Ⅳ.C、LN，最后是PLD。     

Ascorbic acid concentrations in dimethylnitrosamine-induced hepatic fibrosis in rats

BACKGROUND: Ascorbic acid is a potent antioxidant and is involved in many metabolic activities including collagen biosynthesis. In the present investigation, ascorbic acid and lipid peroxides were monitored in the blood and liver samples during the progression of experimentally induced hepatic fibrosis. METHODS: Liver injury was induced by intraperitoneal injections of dimethylnitrosamine (DMN) on three consecutive days of every week over a period of 21 days. The progression of fibrosis was assessed by histopathological examination and by monitoring of the collagen content of the liver tissue. Ascorbic acid and lipid peroxides were monitored in both blood and liver samples on days 0, 7, 14, and 21 after the start of DMN administration. The liver total protein was also measured during the investigation. RESULTS: Histopathological examination demonstrated centrilobular necrosis, fibrosis, and early cirrhosis during DMN treatment. The collagen content increased four-fold on the 21st day of investigation. Lipid peroxides were elevated significantly in both blood and liver specimens on days 7, 14, and 21. A drastic decrease was observed in the ascorbic acid concentrations in both liver and blood samples on all days after the start of DMN administration. Liver total protein concentrations were significantly reduced during DMN administration. CONCLUSIONS: The exact mechanism of the decrease of ascorbic acid during DMN-induced hepatic fibrosis is not clear. The most probable reason for the decreased blood and liver ascorbic acid during DMN-induced hepatic fibrosis is the increased utilization of ascorbic acid for free radical scavenging in order to reduce the highly elevated oxidative stress.     

血清透明质酸检测在小儿肝病中的诊断价值

目的探讨小儿肝病患者血清透明质酸含量的价值。方法用放射免疫测定法检测83例小儿肝病患者和40例正常小儿和成人的血清透明质酸含量价值。结果血清透明质酸浓度在小儿肝病各组均升高,尤以肝硬变升高明显;除慢活肝显著低于成人组外,其它各组与成人组无差异。血清透明质酸水平与总胆红素、凝血酶原时间及γ-球蛋白均有良好的正相关关系,与A/G值负相关。结论血清透明质酸水平在小儿肝病中的变化与成人不同。血清透明质酸检测对小儿肝病的诊断、预后判断及病情监测有良好的参考价值。     

Diagnostic significance of type IV collagen and hyaluronic acid in the serum of patients with chronic hepatitis C for staging hepatic fibrosis

AIM: To evaluate diagnostic value of serologic fibrosis markers (hyaluronic acid--HA and type IV collagen C-IV) in patients with chronic hepatitis C (CHC) and hepatic cirrhosis (HC). MATERIAL AND METHODS: HA and C-IV were measured in 88 CHC patients with fibrosis stage 1 (n = 63) and 3 (n = 25), 13 patients with acute hepatitis C (AHC), 28 patients with hepatic cirrhosis (HC), 19 patients with pulmonary fibrosis (PF). The control group consisted of 32 healthy subjects. RESULTS: HA concentrations in the serum of CHC patients with mild to severe inflammation and fibrosis (F1 and F3) were normal (100 ng/ml). For HC diagnosis, HA test proved highly sensitive and specific (in HA 100 ng/ml sensitivity was 100%, specificity 84.6%), but this method cannot stage hepatic fibrosis. HA test was inferior to C-IV test. A mean C-IV concentration in the serum of CHC patients at the stage of marked fibrosis (F3) is significantly higher than in F1, in HC (A) patients higher than in patients with CHC F3. CONCLUSION: It is shown than concentration of C-IV above 196 ng/ml can differentiate fibrosis stage 1 from stage 3 with specificity 58.7 and sensitivity 88%.     

肝纤维化时血清Ⅳ型胶原蛋白的临床意义

本试验采用一种新的检测方法——乳胶透射比浊法检测118例肝病患和20名正常人血清Ⅳ型胶原蛋白（Ⅳ-C）浓度及其他肝功能指标水平．以探讨血清Ⅳ-C浓度对不同肝脏疾病的临床诊断价值。     

Preventive effect of malotilate on dimethylnitrosamine-induced liver fibrosis in the rat

Dimethylnitrosamine-induced liver damage, which leads to hepatic failure and death of the animal, was prevented by treatment with malotilate. The accumulation of collagen and the morphologic changes caused by dimethylnitrosamine, such as inflammatory cell accumulation and fibrosis, were also prevented by this drug. Malotilate drastically reduced the increases in the amount of type I procollagen alpha 2-chain mRNA and activities of the enzymes prolyl 4-hydroxylase and galactosylhydroxylysyl glucosyltransferase, which are early events in liver fibrosis preceding the deposition of collagen. Even when started 14 days after dimethylnitrosamine induction, malotilate treatment was able to reduce liver damage. We suggest that the effect of malotilate is a result of the inhibition of inflammation.     

Logistic-regression model for assessing portal hypertension by measuring hyaluronic acid (hyaluronan) and laminin in serum

We earlier observed a positive correlation between portal venous pressure (PVP) and the concentration of laminin in serum. Here we investigated whether the diagnostic efficacy could be improved by considering additional analytes and application of multivariate statistical analysis. In 102 patients with fibrotic liver disease of various etiologies we measured PVP as the gradient of the wedged and free hepatic venous pressures and determined the concentrations of hyaluronic acid and laminin in serum. Regression coefficients established by logistic regression in this group were subsequently used to predict portal hypertension (PVP greater than mmHg) in an independent group of 45 patients. By comparison with the known PVP, we obtained a sensitivity of 0.83 (confidence interval: 0.63-0.93) and a specificity of 0.82 (0.61-0.93) for diagnosis of portal hypertension by means of the concentrations of hyaluronic acid and laminin in serum. Application of the model is suggested as a tool for pre-screening and monitoring patients to be subjected to assessment of portal hypertension.     

全身炎症反应综合征患者血清前白蛋白和透明质酸变化及意义

目的　观察全身炎症反应综合征 (SIRS)患者血清前白蛋白 (PAB)和透明质酸 (HA)水平变化并探讨其临床意义。方法　符合SIRS诊断 4 8例 ,清晨空腹抽肘静脉血 5mL ,采用免疫散射比浊法检测PAB含量 ,放射免疫法检测HA含量 ,并选择健康体检者 4 1例作为对照组。结果　SIRS患者血浆PAB含量比对照组显著下降 (P <0 0 1) ;而血浆HA水平与对照组比较明显升高 (P <0 0 1) ;氧合指数与对照组比较无显著差异 (P >0 0 5 )。器官功能不全组血浆PAB含量比器官功能正常组更低 (P <0 0 5 ) ;而血浆HA水平高于器官功能正常组 (P <0 0 1)。结论　SIRS患者血浆PAB、HA水平变化可作为判断病情和监测MODS发生的敏感指标 ,并提示在治疗疾病过程中护肝治疗是重要一环。