乙型肝炎肝硬化患者血清GP73和相关指标的检测及其临床应用价值分析

目的：探讨乙型肝炎肝硬化患者血清中高尔基体蛋白-73（GP73）的水平与相关肝纤维化指标的关系及其临床应用价值。方法选择11例急性乙型肝炎（AHB）患者、31例慢性乙型肝炎（CHB）患者、71例乙型肝炎肝硬化（LC）患者、23例肝癌（PHC）患者和34例健康体检者作为研究对象，采用 ELISA定量检测其血清中 GP73水平，采用放射免疫法检测血清中Ⅳ型前胶原（Ⅳ-C）、透明质酸（HA）水平，同时观察 GP73与相关肝纤维化指标的关系及临床动态变化。结果 CHB组、LC组和PHC组血清GP73水平（μg／L）分别为118.0±82.2，154.4±87.7和196.5±89.6，与正常对照组比较，差异有统计学意义（t值分别为－7.284，－7.909，－9.609，P均＜0.01）；随着肝硬化的进展，血清 GP73，Ⅳ-C和 HA水平逐渐升高，且 GP73与Ⅳ-C和 HA呈明显正相关（r值分别为－0.212，0.487，P＜0.01）。结论 GP73在慢性肝病尤其是乙肝肝硬化中表达明显升高，GP73可能与乙肝肝纤维化的发生有明显的相关性，可作为判断肝纤维化程度的一个较好监测指标。

Clinical Value of Detecting Serum GP7 3 and Related Indexes of Liver Fibrosis Levels in Patients with Hepatitis B Cirrhosis

Objective To investigate the relationship between serum Golgi protein-73 （GP73）level and related indexes of he-patic fibrosis in patients with hepatitis B cirrhosis diseases and discuss the clinical value of GP73.Methods The level of GP73 was detected by ELISA;the levels of type Ⅳ precollagen （Ⅳ-C）and hyaluronic acid （HA）were measured by radio-immunity in serum from 11 patients with acute hepatitis B （AHB）,31 patients with chronic hepatitis B （CHB）,71 patients with Hepatitis B Cirrhosis （LC）,23 patients with primary hepatic carcinoma （PHC）and 34 healthy people with check-up. The clinical changes and relationship between the GP-73 level and the parameter of fibrous degeneration were studied.Re-sults The GP73 level in CHB group was 118.0±82.2μg/L;the GP73 level in LC group was 154.4±87.7μg/L and the GP73 level in PHC group was 196.5±89.6μg/L.Compared with the normal control group,statistically significant differ-ence were found in GP73 level of CHB group,LC group and PHC group （t values were -7.284,-7.909 and -9.609,re-spectively;P〈0.01）.As the progress of liver cirrhosis,the levels of GP73,Ⅳ-C and HA all increased gradually and the level of GP73 was significantly positively correlated to Ⅳ-C and HA （r valves were -0.212 and 0.487,respectively;P〈0.01）. Conclusion The GP73 was high expressed in chronic liver disease,especially in liver cirrhosis.The GP73 was significantly associated with the occurrence of hepatitis b liver fibrosis.There fore,GP73 could be used as a better index to monitor the fi-brosis degree.