慢性乙型肝炎患者TGF-β1及肝纤维化4项指标与肝脏病理分级分期的关系

目的探讨肝病患者转化生长因子-β1（TGF-β1）水平、肝纤维化标志物（HA、LN、CIV、PⅢP）、HBV—DNA及丙氨酸氨基转移酶（ALT）与肝脏炎症分级和纤维化分期的关系。方法测定80例肝病患者血清TGF—β1、HA、LN、CIV、PⅢP、HBV—DNA、ALT，同时对30例慢性乙型肝炎患者行肝穿刺活检并进行病理分级分期，分析TGF-β1、HA、LN、CIV、PⅢP、HBVDNA、ALT与肝脏病理分级分期的关系。结果乙型肝炎患者血清TGF—β1水平随肝纤维化程度加重而升高，各期之间有显著性差异，但其在肝脏炎症各级之间差异无统计学意义（P〉0．05）；肝纤维化各期和炎症各级之间HBV—DNA、ALT均无明显差异（P〉0．05）；TGF-β1变化趋势与HA、LN、CIV、PⅢP均呈正相关（P〈0．05）。结论血清TGF—β1水平与乙型肝炎患者纤维化程度密切相关，且不受肝组织炎症程度的影响，血清TGF-β1水平测定有助于肝纤维化的早期诊断。

Relationship among serum level of TGF-β1, hepatic fibrosis indices(HA, LN, CIV and PⅢP)and hepatic fibrosis stage, hepatic grade in patients with chronic hepatitis B

Objective To study the relationship of transforming growth factor β1 (TGF-β1), hyaluronic acid (HA), laminin (LN), type Ⅳ collagen (CIV), type Ⅲ precollagen (PⅢP), HBV-DNA, alanine aminotransferase (ALT) and hepatic fibrosis stage and hepatic grade in patients with chronic hepatitis B.Methods Serum levels of TGF-β1, HA, LN, CIV, PⅢP, HBV-DNA and ALT were measured in 80 patients with liver diseases, and needle biopsy of liver was performed in 30 patients with chronic hepatitis B, and so was hepatic fibrosis stage and hepatic grade. The relationship among them was analyzed.Results Serum level of TGF-β1 was elevated along with the degree of hepatic fibrosis, and there were significant differences among various stages (P<0.05), but the differences weren't significant among various grades (P>0.05). There weren't significant differences of HBV-DNA and ALT among various stages and various grades (P>0.05). Serum level of TGF-β1 was positively correlative to variation of HA, LN, CIV and PⅢP (P<0.05).Conclusion Serum level of TGF-β1 is closely associated with the degree of hepatic fibrosis in patients with hepatitis B, which is not influenced by hepatic grade, helpful for early diagnosis of hepatic fibrosis.