非酒精性脂肪肝透明质酸、Ⅲ型前胶原肽、Ⅳ型胶原、层黏蛋白改变分析

目的探讨非酒精性脂肪肝患者血清透明质酸(HA)、Ⅲ型前胶原肽(PⅢP)、Ⅳ型胶原(Ⅳ-C)、层黏蛋白(LN)含量变化及其临床意义。方法经B超诊断的非酒精性脂肪肝患者采用放免法检测HA、PⅢP、Ⅳ-C、LN含量并以正常健康组作为对照。结果非酒精性脂肪肝组HA、PⅢP、Ⅳ-C、LN含量高于正常对照组,P<0.01,升高阳性率也高于正常对照组。结论非酒精性脂肪肝患者存在不同程度肝纤维化,以上指标检测对其肝纤维化判断有重要意义。     

慢性乙型肝炎患者血清肝纤维化指标水平及检测意义

目的探讨血清4项肝纤维化检测指标[透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)]在慢性乙肝患者血清中的水平及检测的临床意义。方法 127例慢性乙型肝炎患者根据肝脏活检的纤维化程度分为S1～S4组,采用化学发光法检测血清HA、LN、PCⅢ、CⅣ水平,另选取健康体检者30例为正常对照组。对各组之间检测结果进行比较,并对4项指标与肝纤维化程度的相关性分析。结果 4项指标水平随肝组织纤维化程度总体呈现上升趋势,S4组的4项指标水平均显著高于S3组,差异有统计学意义(P 0. 05);肝脏组织纤维化程度分期与血清4项肝纤维化指标呈正相关性(P 0. 01);肝纤4项指标对肝脏纤维化程度≥S1的AUC分别为0. 862(HA)、0. 721(LN)、0. 858(PⅢ)、0. 814(CⅣ),灵敏度由高至低为PⅢ HA CⅣ LN,特异度为HA LN PⅢ CⅣ。结论活动性进展期的慢性乙型肝炎患者,肝纤4项检测结果能较好的反应肝纤维化程度,对临床的诊断,治疗效果监测及预后判断具有重要意义。     

慢性肝炎肝组织中糜酶浓度与血清肝纤维化指标的相关性分析

[目的]研究慢性肝炎肝组织中糜酶浓度与透明质酸(HA)、Ⅲ型前胶原(PⅢP)、层粘蛋白(LN)、Ⅳ型前胶原(C-Ⅳ)等血清肝纤维化标志物及肝纤维化程度的相关性。[方法]65例慢性肝炎患者经肝脏活检后常规病理检查,取一部分肝组织采用酶联免疫吸附实验(ELISA)检测肝组织中糜酶浓度,同时采血检测血清肝纤维化标志物。观察不同的纤维化分期(S1~S4),其肝组织中糜酶浓度。[结果]肝组织中Chymase浓度与HA、PⅢP、LN、C-Ⅳ呈正相关性(r=0.227~0.251),P﹤0.05;慢性肝炎纤维化分期重的S3和S4患者,其肝组织中糜酶浓度(S3 S4=(38.3±25.6)ng/mg)明显高于纤维化轻的S1和S2患者(S1 S2=(6.8±4.9)ng/mg),P﹤0.01。[结论]肝组织中糜酶浓度可能与慢性肝炎肝纤维化关系密切。     

血清透明质酸、Ⅳ型胶原、层粘蛋白水平与慢性乙型肝炎肝纤维化的关系

目的：研究血清肝纤维化指标透明质酸（HA），Ⅳ型胶原（ⅣC）及层粘蛋白（LN）与慢性乙型肝炎肝纤维化的关系。方法：对252例慢性乙型肝炎患者用放射免疫法检测血清HA，ⅣC，LN水平及定量PCR检测血清HBV－DNA，结果：血清HA，ⅣC，LN水平与慢性肝炎发展呈正相关，且在慢性重度肝炎及肝硬化阶段处于最高水平（P＜0．01），结论：血清HA，ⅣC，LN水平可不同程度反映肝纤维化程度，可作为肝纤维化血清检测指标。     

不同HBV DNA载量慢性乙型肝炎患儿肝脏病理 肝功能及血纤维化指标变化对照研究

目的探讨不同乙型肝炎病毒脱氧核糖核酸(HBV DNA)载量慢性乙型肝炎患儿肝脏病理、肝功能及血纤维化指标变化。方法选取诊治的慢性乙型肝炎患儿100例根据HBV DNA载量不同分为低载量组(103拷贝/mlHBV DNA载量≤105拷贝/ml) 22例、中载量组(105拷贝/mlHBV DNA载量≤107拷贝/ml) 48例和高载量组(HBV DNA载量107拷贝/ml)30例,取活检组织电镜下观察肝脏病理变化,抽取外周静脉血检测丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、血清层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原cⅣ值。结果各组患儿肝脏病理炎症分级均未出现G4级,以G1级为主;纤维化分期未出现S3和S4,以S1为主,其次为S0;患儿肝脏病理炎症分级、纤维化分期各组间比较差异无统计学意义(P0.05)。各组患儿血清ALT、AST比较差异有统计学意义(P0.05),各组LN、HA、PCⅢ、Ⅳ型胶原cⅣ水平比较差异无统计学意义(P0.05)。结论慢性乙型肝炎患儿HBV DNA载量不同时肝脏病理炎症分级及纤维化分期无明显不同,但随着HBV DNA载量升高肝功能明显存在变化,血纤维化指标无明显变化,因此慢性乙型肝炎患儿应血清指标结合肝活组织病理检查才能更加准确及客观地评估病情。     

肝病患者肝纤维化血清标志物与临床意义初探

为了探讨肝纤维化血清标志物对慢性肝病的诊断价值,采用放射免疫分析(RIA)法检测患者血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型胶原前体(PC Ⅲ)、Ⅳ型胶原(ⅣC).结果显示,肝纤维化血清标志物在慢性肝病中均升高.提示肝纤维化血清标志物的动态检测有助于了解慢性肝病患者的肝脏病变程度.     

肝炎肝硬化患者血清纤维化指标含量变化与Child—Pugh分级的相关性

目的探讨血清透明质酸（HA）、层粘连蛋白（LN）、Ⅲ型前胶原肽（PⅢP）、Ⅳ型胶原（CⅣ）与Child—Pugh分级的相关性。方法全部病人依据肝功能Child—Pugh分级分为A、B、C三级，采用ELISA法检测了所有患者的透明质酸（HA）、层粘连蛋白（LN）、Ⅲ型前胶原肽（PⅢP）、Ⅳ型胶原（CⅣ）血清水平，三组病人进行了比较。结果肝炎肝硬化病人的血清透明质酸（HA）、层粘连蛋白（LN）、Ⅲ型前胶原肽（PⅢP）、Ⅳ型胶原（CⅣ）的升高幅度与肝储备功能Child—Pugh分级相一致。结论肝炎肝硬化时，纤维化程度越高，提示肝脏储备功能越差。     

阿得福韦酯治疗慢性乙型肝炎的临床观察

目的 探讨阿得福韦酯治疗慢性乙型肝炎对患者血清纤维化指标的影响. 方法 对60例慢性乙型肝炎患者阿得福韦酯治疗前和治疗1年后血清透明质酸(HA)、层黏蛋白(LN)、Ⅲ前胶原(PcⅢ)和Ⅳ型胶原(Ⅳc)测定水平进行检测. 结果 治疗组血清肝纤维化指标有明显的下降(P＜0.01);与对照组比较差异有统计学意义(P＜0.01). 结论 慢性乙型肝炎经阿得福韦酯治病1年后肝纤维化指标有明显降低.     

氧化苦参碱的抗肝纤维化作用及其机制研究

目的　观察氧化苦参碱的抗肝纤维化作用并探讨其作用机制。方法　采用四氯化碳诱导的小鼠肝纤维化模型观察氧化苦参碱干预前后肝指数、血、肝脏生化及病理组织学改变。比较治疗前后肝纤维化血清学检查指标变化 :透明质酸 (HA)、Ⅲ型前胶原肽 (PⅢP)、层连蛋白 (LN)、Ⅳ型胶原 (Ⅳ -C)。结果　在小鼠肝纤维化模型中 ,氧化苦参碱预防组较四氯化碳组的血清学指标 (HA、PⅢP、LN、Ⅳ -C)明显降低 (P <0 0 5 ) ,肝组织内SOD升高 ,MDA降低 ,病理组织学检查明显改善。结论　氧化苦参碱通过抑制肝内胶原合成、减少肝脏细胞外基质异常增生、降低自由基生成和减轻脂质过氧化发挥抗肝纤维化作用。     

胃癌患者血清HA、PⅢP、Ⅳ-C、LN含量变化及临床意义

目的 :探讨胃癌患者血清透明质酸 (HA)、Ⅲ型前胶原肽 (PⅢP)、Ⅳ型胶原 (Ⅳ -C)、层粘连蛋白 (LN)含量及临床意义。方法 :采用放射免疫技术测定了 48例胃癌患者HA、PⅢP、Ⅳ -C、LN含量 ,并以消化性溃疡及正常健康组作为对照。结果 :胃癌组血清HA、PⅢP、Ⅳ -C、LN含量显著高于正常组 ,P <0 .0 1～ 0 .0 0 1,肝转移组高于肝未转移组 ,P <0 .0 5～ 0 .0 1,胃癌组HA、PⅢP高于消化性溃疡组 ,P <0 .0 5～ 0 .0 0 1。结论 :胃癌组血HA、PⅢP、Ⅳ-C、LN含量与肿瘤肝转移相关     

Evaluation of liver function before living donor liver transplantation and liver resection

Liver resection is the curative therapeutic option for hepatocellular carcinoma, biliary tumors, metastases of colorectal and other extrahepatic tumors, living donor liver transplantation and other benign liver diseases. AIM OF STUDY: To summarize the evaluation methods of liver function before living donor liver transplantation and liver resection. METHOD: We summarize the literature about the evaluation of liver function. RESULTS: Perioperative mortality is determined mostly by the extent of preoperative evaluation focused on the liver. After resection the remnant liver parenchyma must cope with the challenge caused by increased metabolism, portal overflow, decreased vascular bed and biliary tract and oxidative stress following the operation. If the remnant liver is unable to grow up to this challenge, acute liver failure occurs. This maintains the necessity of determining the hepatic functional reserve and the hepatic remnant volume. Child-Pugh classification is widely spread to predict outcome. Dynamic functional tests such as indocyanin green retention test, galactosyl human serum albumin scintigraphy and aminopyrin breath tests can be used to evaluate hepatic reserve. To determine remnant liver volume modern imaging processes such as CT volumetry and hepatobiliary scintigraphy are available. CONCLUSION: After the detailed evaluation resection can be limited to an extent which is oncologically radical enough (1% remnant liver tissue/kg) and spares parenchyma which can ensure survival yet. With careful preoperative examination mortality can be reduced even to reach zero.     

Fatty liver

Fatty liver is increasingly becoming more problematic from a clinical perspective. This article describes fatty liver and its clinical presentation. The current understanding of processes underlying fatty liver is reviewed, as well as the evidence for therapeutic options.     

Nutrition in chronic liver disease and liver transplantation

Significant contributions to the field of nutrition and liver disease have been published in the last year. The most relevant includes work on the pathogenic role of energy metabolism disturbances in the development of malnutrition in cirrhosis, as well as data on the relationship between preoperative nutritional deficiencies and the outcome of liver transplantation. However, despite these contributions, large-scale multicentric trials on the therapeutic value of nutritional support and metabolic care in cirrhosis and liver transplantation are still lacking.     

Subscapular liver hematoma and liver hemorrhage in neonatal age

By analysing their newborn patients of 15 years the authors confirm the earlier observation, that the subcapsular haematoma is a common finding at postmortem examination of the newborns dying during neonatal period. The association of the pathological symptoms of hypoxic origin of the other organs observed at autopsy and the decreasing incidence of subcapsular haematoma as a results of obstetrical and neonatal intensive care make this disease of hypoxic origin probable. In spite of common subcapsular haematoma the haemorrhage of liver causing haemascos is relatively uncommon. In their five patients suffering from liver rupture they observed two types of this (immediate and delayed rupture of liver's capsule), which also differed from one another in their clinical picture. They are drawing attention to general use of ultrasound in diagnostics which means a new chance to diagnosis in alive of both types.