慢性乙型肝炎患者血清瘦素测定的临床意义

目的：探讨血清瘦素表达水平及与血清透明质酸（HA）、Ⅲ型前胶原（PCⅢ）、Ⅳ型胶原（CⅣ）、层粘连蛋白（LN）相关性在慢性乙型肝炎及肝硬化发病中的意义。方法：酶联免疫吸附试验（ELISA）检测65例慢性乙型肝炎、乙型肝炎肝硬化患者和15例健康体检者血清瘦素水平；放射免疫法（RIA）检测血清HA、PCⅢ、C1V、LN。结果：（1）血清瘦素水平在慢乙肝、肝硬化组明显高于对照组（P〈0．001）。（2）在对照组、慢乙肝组及肝硬化组中女性瘦素水平明显高于男性（P〈0．01）。（3）血清瘦素与PCⅢ、LN、CⅣ、HA呈正相关（P〈0．01）。结论：慢性乙型肝炎患者血清瘦素水平随病情加重趋于升高；女性瘦素水平显著高于男性，存在性别差异；测定血清瘦素并分析其与PCⅢ、LN、CⅣ、HA的相关性．可对肝纤维化程度做出较合理的诊断。

The detection and clinical significance of serum leptin in patients with chronic hepatitis B

Objective:To investigate the expression levels of serum leptin in patients with chronic hepatitis B(CHB), correlation between serum leptin and serum hyaluronic acid (HA),procollagen type Ⅲ (PCⅢ), procollagen type Ⅳ (CⅣ), laminin (LN),and discuss the significance in CHB and cirrhosis. Methods:The levels of serum leptin in 65 CHB,cirrhosis induced by hepatitis B and 15 healthy volunteers were detected by enzyme-linked immunosorbent assay(ELISA); serum PCⅢ, LN, CⅣ and HA were detected by radioimmunoassay(RIA). Results:(1)Serum leptin level in patients with chronic hepatitis and cirrhosis was significantly higher than that of the control group(P<0.001). (2)Female leptin level in the control group, CHB and cirrhosis group was significantly higher than that of male(P<0.01). (3)Levels of serum leptin and serum PCⅢ, LN, CⅣ, HA were positively correlative(P<0.01).Conclusions: Expression levels of serum leptin in the CHB patients increase with the severity of disease;Female leptin level is higher than that of male, suggesting serum leptin level is associated with gender difference; Comprehensive analysis of serum leptin and PC-Ⅲ, LN, CⅣ, HA can make a reasonable decision about the degree of hepatic fibrosis and provide effective experimental basis for clinical treatment.