血清HA及CG多学科不同病种临床分析

目的:探讨血清透明质酸(HA)及甘胆酸(CG)水平在不同疾病中的变化。方法:本文采用放射免疫分析(R IA)测定了78例慢性肝病、32例原发性肝细胞癌、70例小儿传染病、50例小儿反复呼吸道感染(RR I)及428例孕妇血清的HA及CG水平。同时还用酵母菌花环法测定了RR I患儿红细胞受体花环率(RBCC3bRR)、红细胞免疫复合物花环率(RBC ICR)、免疫比浊法测定了血清IgG、IgM、IgA、C3水平,部分病例还测定了ALT、SF等相关指标。结果:慢性肝病除CPH组HA水平较对照组无显著差异(P>0.05)外,其余3组CG、HA及SF水平均较对照组升高极显著(P均<0.01),PHC组CG、HA升高水平与4个月存活率呈显著正相关(r及P见表2)。孕妇组则除早孕组CG、HA水平较对照组差异不显著(P均>0.05)外,中孕组及晚孕组升高均显著及非常显著(P均<0.05,P均<0.01)。小儿传染病组除流腮组HA及ALT,菌痢组ALT较对照组差异极显著(P均<0.01)外,其余组CG、HA及ALT 3项指标也升高显著(P均<0.05);RR I组结果显示,RBCC3bRR(%)、CG、C3及IgG水平显著高于对照组(P均<0.05),RBC IC(%)、HA、IgA及IgM与对照组比较差异无显著性(P均>0.05)。结论:小儿细菌或病毒感染可引起轻度肝损伤,且与机体的免疫功能低下关系密切。慢性肝病CG、HA及SF水平的变化与肝损害关系密切;PHC患者CG、HA变化与4个月存活率呈正相关;孕妇HA及CG水平随孕周增加而升高,其测定有助于了解孕妇的胆汁酸代谢状况及肝损害程度。

Study on the Changes of Serum HA and CG Levels in Several Diseases Besides Liver Disorders

Objective To study the changes of serum hyaluronic acid(HA) and cholyglycine(CG) in several diseases besides liver disorders.Methods Serum HA and CG levels were measured with RIA in 78 patients with chronic liver diseases(with 70 controls),(84 patients with primary hepatic carcinoma),70 pediatric patients with various infections diseases(with40 controls),50 pediatric patients with recurrent respiratory infection(RRI,with 30 controls) and 428 pregnant women(with 60 controls).In addition,RBC C_3b receptor ratio(RBCC_3bRR) and RBC immune-complex ratio(RBCICR)(both with yeast rossette method) as well as serum IgG,IgM,IgA,C_3 levels(with immunoturbidity test) were examined in the 50 RRI pediatric patients,ALT levels were examined in the 70 pediatric patients with infectious diseases and SF examined in the 78 patients with chronic liver diseases.Results The serum CG,HA and SF levels in the three groups of patients with chronic liver diseases(CPH,CAH,Cirrhosis) were significantly higher than those in the controls(all P<0.01) with the exception of HA in CPH patients(P>0.05).In patients with hepatic carcinoma,the CG and HA levels were positively correlated with the mortality at 4 months(P<0.05).Among pregnant women, serum levels of HA and CG were significantly during the second and third trimesters(P<0.05~0.01) than those in the controls but not so during the first trimester.In the pediatric patients with infectious diseases,CG and HA levels were significantly higher in all these patients(P<0.01) with the only exception of HA in patients with mumps(P>0.05).For ALT,levels only incrased in patients with hepatitis and typhoid fever with none in bacillary dysentery and mumps.In pediatric patients with RRI,RBCC_3bRR(%),CG,C_3,IgG levels were significantly higher than those in controls(P<0.05) with no significant differences in the case of RBCICR(%),HA,IgM and IgA levels(P>0.05).Conclusion Various infectious diseases in pediatric patients could induce mild liver damage,which was closely related to the depressed immune status.High CG and HA levels in liver cancer patients suggested high mortality at 4 months.Women in late pregnancy might harbour disturbances in CG metuabolism and mild liver injury though without overt symptoms.