摘要
目的：探讨血清透明质酸（ＨＡ）对肝纤维化诊断的临床意义。方法：用放射免疫法测定１６４例各型病毒性肝炎患者治疗前后血清ＨＡ水平，其中６６例慢性肝病患者做肝穿刺活检，活检同时测定血清ＨＡ。比较各组肝炎之间ＨＡ差异、各组治疗前后ＨＡ变化及ＨＡ与肝组织分级、分期相对照。结果：血清ＨＡ水平随着肝纤维化发展而升高，在肝硬化组最高，与各组比较均有显著差异（Ｐ＜００５）。ＨＡ与肝内炎症、坏死及肝纤维化程度呈正相关，ｒ分别为０４６和０６２（Ｐ＜００５）。以血清ＨＡ大于正常组ＨＡｘ＋２ｓ（ＨＡ＞１３０ｎｇ／Ｌ）为判断肝纤维化标准，与病理诊断相比较，则ＨＡ对肝纤维化诊断的敏感性为４５０％，特异性为８４６％。结论：ＨＡ对肝纤维化诊断有临床应用价值。由于ＨＡ与肝内炎症、坏死亦有关，故对于静止期肝炎来说，ＨＡ明显升高对肝纤维化的存在有提示意义，诊断价值也更高。
Objective: To evaluate the predictive value of elevated serum hyaluronic acid(HA) in the diagnosis of hepatic fibrosis.Methods:The serum HA levels were measured in 164 patients with various viral hepatitis and 30 healthy blood donors by radioimmunoassay. Among them, percutaneous liver biopsy were performed in 66 patients with chronic hepatitis. Results:HA level was significantly higher in liver cirrhosis than healthy controls and patients with noncirrhotic liver disease (P<0.05). The serum levels of HA was correlated with the stages of fibrosis (r =062) and grades of inflammation and necrosis (r =046) of the liver, but more closely correlated with stages of fibrosis (P<0.05). The upper limit of normal values ([AKx-D8]+2s) for serum levels of HA was 130 ng/L. The patients whose serum HA level higher than 130 ng/L were considered as hepatic fibrosis, compared with the hepatic histologic findings, the HA sensitivity and specificity for diagnosing hepatic fibrosis were 0.45 and 0.846, respectively. Conclusions:These findings suggest that determination of serum hyaluronate concentration may be valuable on predicting hepatic fibrosis.
出处
《中山医科大学学报》
CSCD
1998年第3期211-213,共3页
Academic Journal of Sun Yat-sen University of Medical Sciences
关键词
透胆质酸
诊断
肝纤维化
hyaluronic acid/blood
liver fibrosis/diagnosis
hepatitis/diagnosis
