摘要
目的 为了解儿童血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PcⅢ)、Ⅳ型胶原(CⅣ)的水平以及在慢性肝炎中的诊断价值。方法 采用酶联免疫吸附试验(ELISA)测定400名1～15岁健康儿童和180名患有慢性肝炎儿童的4项肝纤维化标志物。结果 4项标志物检测结果(x±s)如下:HA(58±16)ng/ml,LN(115±17)ng/ml,PcⅢ(146±27)ng/ml,CⅣ(51±16)ng/ml。HA、CⅣ与年龄不相关(r=-0.022,P>0.05;r=0.070,P>0.05),而LN与年龄显著相关(r=0.128,P<0.01),PcⅢ与年龄呈负相关(r=-0.669,P<0.01)。慢性表面抗原携带者与同龄对照组差异无显著性。轻度慢性肝炎患儿除HA显著性高于对照组(P<0.05)外,其他3项均无差异。中度、重度及肝硬化儿童的4种血清标志物浓度均高于正常对照组(P<0.01)。在中度、重度及肝硬化儿童中,有2种或3种以上的标志物显著性增加。结论 4项标志物在儿童期有其年龄特征。它们可反映慢性肝炎患儿肝纤维化的严重程度。因此,对慢性肝炎和早期肝硬化的诊断有临床应用价值。
Objective To investigate possible diagnostic value of serum hyaluronic acid (HA), laminin (LN), type Ⅲ procollagen (PcⅢ ) and type Ⅳ collagen (CⅣ) levels in children with chronic hepatitis. Methods The 4 serum markers for liver fibrosis were determined in 400 normal children 1 - 15 years of age in 5 age groups and 180 children with chronic hepatitis by using ELISA. Results The results of determination of the 4 markers were as follows (M±s):HA (58 ± 16) ng/ml,LN(115±17)ng/ml,PcⅢ (146±27) ng/ml,CⅣ (51 ± 16) ng/ml. The upper limit of 95% normal reference values of the 4 serum markers were calculated mean value plus 1.645s, the results of calculation were HA85ng/ml, LN142 ng/ ml,PcⅢ 190,CⅣ77ng/ml,espctively. NO correlation was found betwwen age and HA,CⅣ (r= - 0.022,P>0.05 and r = 0.070,P>0.05);however,LN significantly correlated with age (r=0.128,P<0.01) and Pc3Ⅲ negatively correlated with age (r= -0. 669, P< 0. 01). The difference between the values of chronic HBsAg carriers and those of the age matched normal controls was not significant; the values of the mild chronic hepatitis patients were not significantly different from those of the controls except for HA, which was higher than that of the controls (P<0.05). The serum concentrations of all these markers in children with moderate to severe chronic hepatitis and cirrhosis were significantly increased as compared to those of the normal subjects (P<0.01), Significant increase 2 or more markers was seen in 100% of patients with moderated and severe chronic hepatitis and liver cirrhosis. Conclusions The present study demonstrated that the 4 serum markers had certain characteristics with regard to the of normal children. The value of the 4 markers had certain characteristics with regard to the of normal children. The values of the 4 markers may reflect the severity of chronic hepatitis in children, and may have potential applicability in clinical diagnosis of chronic hepatitis and early cirrhosis.
出处
《海南医学》
CAS
2003年第10期27-29,共3页
Hainan Medical Journal
