摘要
目的探讨慢性肝炎中纤维化分期与血清学检测指标的关系。方法共收集慢性病毒性肝炎、肝硬化肝穿标本及尸检肝组织１２７例（其中尸检１３例），各例均同时采血做肝功能化验及纤维化血清学指标Ⅲ型前胶原肽、Ⅳ型胶原、层粘连蛋白、金属蛋白酶组织抑制物及透明质酸的检测。肝组织石蜡切片，作ＨＥ、网织纤维、弹力纤维、及狼红染色（偏光镜下分辨Ⅰ、Ⅲ型胶原），免疫组化染色显示Ⅳ型胶原、层粘连蛋白、及活化星状细胞。结果本文对１２７例中９２例慢性病毒性肝炎（包括早期肝硬化）及１８例结节性肝硬化进行分析（另１７例为酒精性肝病）。通过９２例慢性病毒性肝炎的病变分析证明炎症活动度与纤维化程度明显相关（ｒ＝０８２，Ｐ＜００１）；纤维化程度与血清学指标Ⅲ型前胶原肽、Ⅳ型胶原、层粘连蛋白、金属蛋白酶组织抑制物及透明质酸呈正相关，相关系数分别为０５７５、０６０７、０６４１、０６０６及０６１。说明肝内纤维化程度加重，纤维化血清学指标升高。对比了慢性肝炎早期肝硬化（Ｓ４，１６例）与结节性肝硬化（１８例）的纤维化血清学指标，证明活动性肝硬化各血清学指标高于早期肝硬化，静止性肝硬化则低于早期肝硬化。结论纤维化血清学指标与组织学纤维化分期明显相关，?
Objective To assess the correlation between serological fibrosis markers and staging of fibrosis in chronic hepatitis. Methods One hundred and fourteen (114) biopsy and 13 autopay liver specimen were reviewed pathohistologically. Serum samples for liver function tests and fibrosis marker assays including serum P III P, IV collagen, laminin (LN), hyaluronic acid (HA), h TIMP 1 were collected simultaneonsly right before the biopsy or autopsy. HE, sirius red stains as well as staining for reticulum and elastic fiber were done. In besides, IV collagen, laminin, activated stellate cell were assayed by immunohistochemical metheds. Results Among 127 patients, 92 cases of chronic viral hepatitis including early cirrhosis and 18 cases of hepatic cirrhrosis were examined pathologically (17 alcoholic liver disease excluded). The overall inflammatory index and fibrotic scoring were noticed to be significantly correlated with each other (r=0.82, p<0.01); The markers, such as HA,P III P, LN, IV collagen, h TIMP 1 were positively correlated with the fibrotic staging and scoring (r=0.610, 0.575, 0 607, 0.641,0.606 respectively). The higher the marker level, the more serious the fibrotic change. In addition, (18 cases) patients with active cirrhosis (16 cases) showed higher serum marker level than that of the early cirrhosis and the serum markers in the later were higher than that in the non active cirrhosis. Conclusion Serum fibrosis markers are fairly well correlated with the staging of fibrosis and are considered to be the valuable references for clinical diagnosis. The close correlation between inflammation process and fibrosis suggests that the inflammatory process plays an important role in fibrogenesis.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
1998年第3期185-190,共6页
Chinese Journal of Pathology
关键词
病毒性肝炎
血清诊断
肝纤维分
分期
Hepatitis, Viral, human Liver cirrhosis Pathology, clinical Serodiagnosis
