男性肝纤维化患者雌激素水平变化的临床意义

目的探讨男性肝纤维化患者雌激素水平的变化以及与血清透明质酸（HA）、Ⅲ型前胶原肽（PⅢNP）、IV型胶原（IV—C）、层粘连蛋白（LN）及肝功损害的关系。方法采用酶联免疫法检测31例健康男性、26例男性慢性肝炎和34例男性肝硬化患者的HA、Ⅳ—C、PⅢNP、LN；同时采用放免法检测上述对象的雌酮（E1）、雌二醇（E2）、雌三醇（E3）。结果肝炎组以及肝硬化组的HA、PⅢNP、Ⅳ—C和LN明显高于正常组（P〈0．05或P〈0．01），且肝硬化组明显高于肝炎组（P〈0．05或P〈0．01）。肝炎组以及肝硬化组的E1、E3明显高于正常组（P〈0．05或P〈0．01），且肝硬化组明显高于肝炎组（P〈0．05或P〈0．01）。三组的E2水平逐渐增高，但是无显著性差异（P〉0．05）。E1、E3浓度与HA、Ⅳ—C呈正相关，E2与两种指标均无明显相关性。结论肝纤维化患者存在不同程度的雌激素水平升高，并且雌酮、雌三醇的升高程度与肝硬化肝功能受损程度有明显关系，测定雌激素水平变化，可以作为临床判断预后、疗效的一个指标。

Change of serum levels of estrogen and clinical significance in the male patients with fibrosis of liver

Objective To explore the relationship between serum levels of estrogen and hyalurnic acid, procollagen -Ⅲ, collagen - Ⅳ and layer mucigen and severity of liver dysfunction in the male patients with fibrosis of liver. Methods HA, P Ⅲ NP,Ⅳ - C, LA were measured by ELISA and E1, E2, E3 were measured by radioimmunoassay in 34 cases cirrhosis , then compared with 26 chronic hepatitis and 31 cases normal. Results In chronic hepatitis group and cirrhosis group ,the hyalurnic acid, HA, PⅢNP, Ⅳ -C and LN are significantly higer than control group（ P 〈 0. 05 or P 〈 0.01 ）. In chronic hepatitis group and cirrhosis group , E1 and E3 levels are significantly higer than control group. That of cirrhosis group higer than hepatitis group. No difference was found in E2 level among three groups（ P 〉0. 05 ）. E1 level and E3 level are correlated positively with HA, Ⅳ - C. E2 levd are not correlated with them. Conclusion Hepatocirrhosis has varying amounts of disorder in levels of estrogen in serum , depending on liver function lesion gravity , the determination of above hormone could be deserved as a standard for clinical state of illness.