慢性肝病患者血清铜蓝蛋白、铁蛋白水平检测的临床意义

目的探讨慢性肝病患者血清铜蓝蛋白（CER）、铁蛋白（SF）水平变化与肝细胞损伤程度的相关性。方法依据2000年全国病毒性肝炎学术会议修订的《病毒性肝炎防治方案》诊断及分型标准，将入选168例病例分为慢性轻度乙肝组35例，慢性中度乙肝组38例，慢性重度乙肝组26例，肝炎性肝硬化组30例，原发性肝癌组39例，另选取健康体检者60例作为对照组，分别采用化学发光法与免疫比浊法测定各组SF、CER含量，分析不同组别血清CER、SF水平与肝细胞损伤程度的相关性。结果血清CER水平：原发性肝癌组〉正常对照组〉慢性重度乙肝组〉肝炎肝硬化组，差异有统计学意义（P〈0．01），慢性轻度乙肝组，慢性中度乙肝组与正常对照组相比较差异无统计学意义（尸〉O．05）。血清SF水平：原发性肝癌组〉肝炎肝硬化组〉慢性重度乙肝组〉慢性中度乙肝组〉慢性轻度乙肝组〉正常对照组，差异有统计学意义（P〈0．01）。结论慢性肝炎由轻度发展到中度、重度乃至肝硬化的过程中，肝细胞受损是一个渐进性的发展过程，在此演变过程中，血清CER水平渐进降低而sF水平则渐进升高，可作为判断肝细胞坏死程度、治疗预后有价值的指标。血清CER原发性肝癌时升高，肝炎肝硬化时降低，可用于二者的鉴别和筛选。

Clinical significance of determination of serum ceruloplasmin and ferritin levels in patients with chronic liver disease

Objective To study the correlation between serum levels of CER （Ceruloplasmin）,SF （ferritin）and the degree of liver cell injury in patients with chronic liver deseases. Methods Totally 168 eases patients were divided into the mild chronic hepatitis B group consisted（35 cases）, moderate chronic hepatitis B group（ 38 cases）, chronic severe hepatitis B group （ 26 cases ）, liver cirrhosis from chronic hepatitis B group （ 30 eases ）, primary liver cancer group （ 39 cases）, according to the 2000 National Academic Conference on viral hepatitis revised＂viral hepatitis prevention and treatment program＂. Another. 60 healthy subjects served as a normal control group.The serum levels of CER and SF were determined respectively by chemiluminescence and immunoturbidimetry. The correlation of serum CER and SF levels with the degree of liver injury in different groups was analyzed. Results The serum levels of CER were in the order of primary liver cancer group〉normal control group〉chronic severe hepatitis B group〉liver cirrhosis from chronic hepatitis B group, showing statistically significant difference （P〈0.01）. While that of mild chronic hepatitis B,moderate chronic hepatitis B group showed no significant difference compared with the normal control group（P〉0.05）. The serum levels of SF：were in the order of primary liver cancer group〉liver cirrhosis from chronic hepatitis B group〉chronic severe hepatitis B group〉 moderate chronic hepatitis B group〉 mild chronic hepatitis B group〉 normal control group showing statistically significant difference （P〈0.01）. Conclusions The liver cell damage is a gradual process of development of chronic hepatitis from mild to moderate, severe stage and even cirrhosis process,the serum CER level is gradual decreased and SF level is gradually progressive increase, that can be used as indicators to judge the degree of liver cell necrosis,treatment and prognosis . The level of serum CER is increased in primary liver cancer, while reduced in liver cirrhosis that would conducive for identification and screening of the disease