老年人群中非酒精性脂肪肝患者血清免疫球蛋白和肝纤维化指标水平的临床评价

目的探讨60岁以上老年体检人群中非酒精性脂肪肝病（NAFLD）患者血清免疫球蛋白（Ig）水平与肝纤维化的关系。方法采用免疫散射比浊法检测112例老年脂肪肝患者和92例健康体检者（对照组）血清IgA、IgG、IgM含量及采用放射免疫吸附试验（RIA）测定其血清透明质酸（HA）、Ⅳ型前胶原肽（IVC）及层黏连蛋白（LN）水平，并分析其相关性。结果老年脂肪肝患者血清IgA、IgG、IgM含量明显高于对照组（P〈0．01）。肝纤维化指标HA、IVC、LN水平明显高于对照组（P〈0．01），而且患者血清IgA、IgG、IgM与HA、IVC、LN之间呈显著正相关（P〈0．01或P〈0．05）。结论老年非酒精性脂肪肝有较为明显的肝纤维化倾向。检测其血清IgA、IgG、IgM与HA、IVC、LN含量，对于脂肪肝纤维化的诊断及评估预后具有重要的临床意义。

The clinical assessment of the serum immunoglobulin and hepatic fibrosis indexes in the older age groups with nonalcoholic fatty liver disease

Objective To assess the serum immunoglobulin and liver fibrosis indexes in the older age groups aged over 60 years old with Nonalcoholic Fatty Liver Disease. Methods Serum immunoglobulin and liver fibrosis indexes, HA, IVC and LN ,were determined in 112 patients with nonalcoholic fatty liver disease diagnosed with B ultrasonic echograph, and take 92 normal volunteer as the control group. At the same time, the results were analysised. Results Serum IgA,IgG,IgM levels in the patients with nonalcoholic fatty liver disease were much higher than those in the control group（ P 〈 0. O1 ）. Serum level of HA ,IVC ,LN in the patients with nonalcoholic fatty liver disease were significantly higher than those of heathy subjects（ P 〈 0. 01 ）. And serum IgA, IgG, IgM are positively correlated to HA, IVC, LN （ P 〈0. 01 or P 〈 0. 05 ）. Conclusion Nonalcoholic Fatty Liver Diseases in older age groups will be prone to hepatic fibrosis. The detection of serum IgA, IgG, IgM and HA, IVC, LN content is truly significant in the diagnosis and prognosis evaluation of hepatic fibrosis.