Objective To investigate the clinical significance of detection of serum fibrosis markers in evaluation of degree of hepatic fibrosis in chronic hepatitis D.Methods 50 patients with chronic hepatitis D without antiviral therapy in our hospital from December 2015 to December 2016 were selected as the research object.The hyaluronic acid (HA), laminin (LN), procollagen Ⅲ peptide (PⅢP), collagen Ⅳ (CⅣ), alanine transaminase (ALT), hepatitis B virus desoxyribonucleic acid (HBV DNA) of patients were detected.The degree of hepatic fibrosis was examined.The serological results, serum indexes at different fibrosis stages of hepatitis D patients were compared.The correlation of serum indexes and cirrhosis stages in hepatitis D patients was analyzed.Results There were 31 cases (62％) of negative HBeAg and 19 cases (38％) of positive HBeAg in 50 cases, and there was no statistical difference in the levels of CⅣ, PⅢP, LN, HA between the two groups (P＞0.05);There was no statistical difference in the CⅣ, PⅢP, ALT, HBV DNA among S1, S2 and S≥3 group (P＞0.05);There was statistical difference in the levels of LN and HA (P＜0.05), and the levels of LN and HA in S≥3 group were the highest;The hepatic fibrosis stages had positive correlation with the levels of CⅣ, PⅢP, LN and HA, that is, the stage was higher, the levels of CⅣ, PⅢP, LN and HA were higher (P＜0.05).Conclusion The hepatic fibrosis stages had positive correlation with the CⅣ, PⅢP, LN and HA.LN and HA can more accurately judge the degree of hepatic fibrosis of hepatitis D patients, they can provide reliable basis for clinical diagnosis and treatment.%目的 探讨血清纤维化标志物检测评估慢性丁型肝炎肝纤维化程度的临床意义.方法 选取2015年12月-2016年12月我院收治的未接受任何抗病毒治疗的50例慢性丁型肝炎患者作为研究对象, 对患者血清纤维化指标透明质酸 (HA) 、层粘连蛋白 (LN) 、Ⅲ型前胶原肽 (PⅢP) 、Ⅳ型胶原 (CⅣ) 、谷丙转氨酶 (ALT) 和乙肝病毒的脱氧核糖核酸 (HBV DNA) 进行检测, 并实行肝活组织检查检测肝组织纤维化程度.比较丁型肝炎患者血清学检测结果、不同纤维化分期血清学指标, 并分析丁型肝炎患者血清学指标与肝硬化分期的相关性.结果50例患者中有31例 (62％) 为HBeAg阴性, 有19例 (38％) 为HBeAg阳性, 两组患者CⅣ、PⅢP、LN和HA水平, 差异无统计学意义 (P＞0.05);S1、S2和S≥3三组间CⅣ、PⅢP、ALT和HBV DNA相比, 差异无统计学意义 (P＞0.05);而LN和HA水平相比, 差异有统计学意义 (P＜0.05), 且S≥3的LN和HA水平最高;肝纤维化分期与CⅣ、PⅢP、LN和HA水平呈正相关, 即分期越高, CⅣ、PⅢP、LN和HA水平越高 (P＜0.05) .结论 慢性丁型肝炎患者肝纤维化分期与CⅣ、PⅢP、LN和HA等血清纤维化标志物指标呈正相关, 且LN和HA指标能够更加准确的判断丁型肝炎患者肝纤维化程度, 为临床诊断治疗提供可靠的依据.
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