联合检测血清透明质酸、Ⅳ型胶原及层黏蛋白对肝纤维化的诊断价值

目的 :探讨血清透明质酸 (HA)、Ⅳ型胶原 (CIV)及层黏蛋白 (LN)联合检测对肝纤维化的诊断价值。方法 :采用酶联免疫法对健康人组 2 2例、急性肝炎组 10例、慢性肝炎组 10例、肝硬化组 2 5例及慢性重症肝炎组 10例 ,分别检测血清HA ,CIV及LN的水平 ;对肝硬化组三项指标分别检测和联合检测所得的敏感性、特异性及准确性进行比较。结果 :血清中HA ,CIV及LN的水平以肝硬化组和慢性重症肝炎组最高 ,均明显高于其它组 (P <0 0 1)。肝硬化组联合检测的敏感性高于单项检测的敏感性 ,但其特异性降低。结论 :联合检测HA ,CIV及LN可提高诊断肝纤维化敏感性 ,但特异性降低 ;其中HA +CIV的敏感性和特异性较高 ,为最优联合

Value of simultaneous determination of serum hyaluronic acid, collagen Type Ⅳ and the laminin level in diagnosing liver fibrosis

Objective To study the value of simultaneous determination of serum hyaluronic acid(HA), collagen Type Ⅳ (CIV) and the laminin (LN) level in the diagnosis of liver fibrosis.Methods Serum HA, CIV and LN were measured by ELISA in 22 healthy persons, 10 cases of acute hepatitis, 10 cases of chronic hepatitis, 10 cases of heary chronic hepatitis, and another 25 cases of posthepatitic cirrhosis. The sensitivity, specificity and accuracy of simultaneous determination were compared with those of single determination in posthepatitic cirrhosis.Results The levels of serum HA, CIV and LN in posthepatitic cirrhosis cases and heary chronic hepatitis cases were significantly higher than those in the other groups (P<0 01). Simultaneous determination of these indices enhanced the diagnostic sensitivity, but decreased the diagnostic specificity.Conclusion Simultaneous determination of HA, CIV and LN can enhance the diagnostic sensitivity. Simultaneous determination of HA and CIV is an optimal choice.