乙肝患者血清学标志物与肝纤维化的关系研究

摘要] 目的 评价血清纤维化指标透明质酸(HA)、Ⅲ型前胶原肽( PⅢP)、Ⅳ型胶原 ( CⅣ)、层粘连蛋白(LN)、纤维连接蛋白（FN）、基质金属蛋白酶(MMP-2) 及其抑制物(TIMP-1)对肝纤维化诊断的价值。方法 采用放射免疫法检测80例肝病患者肝纤维化血清学标志物水平，并与患者的肝组织病理学检查作对比。结果 肝纤维化血清指标HA、PⅢP、CⅣ、LN、MMP-2、TIMP-1，大部分指标纤维化各期及炎症各级的值比正常人显著升高（P<0.05或0.01）；仅FN指标，肝纤维化患者显著降低(P<0.05或0.01)。血清HA、PⅢP、CⅣ、LN、MMP-2、TIMP-1与肝纤维分期显著正相关（P<0.05或0.01）；与炎症分级显著正相关（P <0.05或0.01）。仅FN与肝脏病理分期、分级显著负相关（P<0.05）。结论　血清纤维化指标与肝纤维化分期分级存在显著相关性，具有重要临床意义。

Correlation between serum markers and liver fibrosis in patients with chronic hepatitis B

ABSTRACT]AIM：To evaluate the clinical value of serum liver fibrosis markers:hyaluronic acid(HA),type Ⅲ precollagen N peptide( PⅢP),type Ⅳ collagen(CⅣ),laminin(LN),fibronectin (FN),matrix metalloproteinase-2(MMP-2),tissue inhibitor of metalloproteinase-1(TIMP-1) in the diagnosis of liver fibrosis.MTHODS：In 80 patients with type B hepatitis(HB),their serum levels of HA,PⅢP,CⅣ,LN, FN,MMP-2,TIMP-1 were detected with EIA and the relationship between the serum makers and liver histological changes were analyzed.Datum were analyzed with SPSS 13.0.RESULTS：Most of serum liver fibrosis markers HA、PⅢP、CⅣ、LN、MMP-2、TIMP-1 in liver fibrosis stages and inflammatory grades of liver fibrosis patients were higher than norm people’s（P <0.05 or 0.01）;only FN of liver fibrosis patients is lower than norm ones’ (P <0.05 or 0.01).There was a significantly positive correlation between serum liver fibrosis markers HA、PⅢP、CⅣ、LN、MMP-2、TIMP-1 and liver fibrosis stages（r=0.247-0.643, P <0.05 or 0.01）and also between serum liver fibrosis markers HA、PⅢP、CⅣ、LN、MMP-2、TIMP-1 and inflammatory grades(r=0.239-0.611,P <0.05 or 0.01).Meanwhile there was a significantly negative correlation between serum liver fibrosis markers FN and liver fibrosis stages,inflammatory grades（r=-0.255,-0.261;P<0.05).CONCLUTIONS：There were significantly correlation between serum liver fibrosis markers and liver fibrosis stages,inflammatory grades. Serum liver fibrosis markers have critical clinical value.