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目的 创建出一套无创、简便易行的诊断肝纤维化的方法。方法 以肝活检为肝纤维化诊断的金标准 ,同时检测肝纤维化和正常对照者血清中的透明质酸、层粘连蛋白、纤粘连蛋白、血清IV型胶原、血清III型前胶原氨基端肽和血清脯氨酸肽酶 (以下分别简称HA、LN、FN、IV -C、PⅢP和PLD) ,并采用多元Logistic回归分析建立诊断方程。 结果 肝硬化组和慢性乙型肝炎 (重度 )以上各指标差别均无显著性意义 ,慢性乙型肝炎 (重度 ) >慢性乙型肝炎 (中度、轻度 ) >正常对照。HA、、LN、PⅢP、IV -C、PLD各因素均进入回归方程。以回归方程预测的肝纤维化T值大于 0 95者做判断肝纤维化的标准 ,结果该法诊断的灵敏度和特异度分别为 86 7%和 80 0 % ,符合率为 85 %。结论 肝细胞基质HA、LN、PⅢP、IV -C、PLD是肝纤维化的诊断的敏感指标 ,联合检测可以对肝纤维化进行定量预测诊断
Objective To create a non-invasive, easy and convenient method of diagnosing liver fibrosis. Methods Liver biopsy was used as the gold standard for the diagnosis of liver fibrosis. Hyaluronic acid, laminin, fibronectin, serum type IV collagen, serum type III procollagen amino terminal peptide in the serum of liver fibrosis and normal controls were also detected. And serum prolyl peptidase (hereinafter referred to as HA, LN, FN, IV-C, PIIIP and PLD respectively), and established the diagnostic equation by multivariate Logistic regression analysis. Results There was no significant difference between the indexes of cirrhosis and those with chronic hepatitis B (severe). Chronic hepatitis B (severe)> Chronic hepatitis B (moderate, mild)> normal control. HA, LN, PⅢP, IV -C, PLD all enter the regression equation. The regression equation predicted T value of liver fibrosis is greater than 0 95 to determine the standard of liver fibrosis, the results of the diagnostic sensitivity and specificity were 86.7% and 80% respectively, with a coincidence rate of 85%. Conclusions Hepatoma cell matrix HA, LN, PⅢP, IV-C and PLD are sensitive indicators for the diagnosis of liver fibrosis. Combined detection can be used to quantitatively predict the diagnosis of liver fibrosis