摘要
目的:探讨肝硬化患者血清中抗心磷脂抗体(ACA)的含量变化及其与肝硬化病情的演变关系。探索抗心磷脂抗体(ACA)与Child -Pugh分级和普通肝功能及肝纤维化指标间的联系与影响。方法:应用酶联免疫吸附法(ELISA)分别对不同分级的肝硬化患者血清中抗心磷脂抗体(ACA)的含量进行了测定;用酶法测定了ALT、AST与胆汁酸并计算AST/ALT值;用Peariman和Lee改良法测定血清胆红素;用溴甲酚氯比色法测定血清白蛋白;用放射免疫分析法测定透明质酸(HA)、Ⅲ型前胶原氮端肽(PⅢNP)、层粘连蛋白(LN )与Ⅳ型胶原(Ⅳ.C) ;并测定了凝血酶原时间(PT)与血小板计数等相关指标。结果:肝硬化患者血清抗心磷脂抗体(ACA)的阳性率Child -PughA、B、C三级逐级升高,随肝硬化病情加重而增加;血清胆红素和凝血酶原时间(PT)与ACA呈显著正相关(P <0 .0 1) ,血清白蛋白与血小板计数与ACA呈显著负相关(P <0 .0 1) ;ALT、AST、AST/ALT、胆汁酸与ACA相关无显著性(P >0 .0 5 ) ;ALT、AST、AST/ALT对ACA的影响有显著性(P <0 .0 1) ,以AST/ALT为最强;透明质酸(HA)、Ⅲ型前胶原氮端肽(PⅢNP)、层粘连蛋白(LN)及Ⅳ型胶原(Ⅳ.C)与ACA均呈显著正相关(P <0 .0 1,P <0 .0 5 ) ;HA、PⅢNP、LN、Ⅳ.C四者中,只有HA与PⅢNP对ACA的影响有显著性(P <0 .0 1) 。
Objective: To investigate the change of content and clinical significance of serum anticardiolipin antibodies(ACA) in cases with hepatic cirrhosis and its relationship between hepatic cirrhosis and the condition, and the association with and effect on ACA classification of Child-Pugh and indices of regular hepatic functions and its fibrosizing. Methods: The serum ACA levels were determined, by ELISA method, in different classifications of cirrhotic cases. Serum ALT,AST,and bile acid were observed by Enzyme assay and the ratio of AST/ALT was worked out. Serum bilirubin was measured by Peariman and Lee method. Serum albumin was tested by Bromphenol assay and was simultaneously measured to Hyaluronic Acid(HA), Type Ⅲ Procollagen(PⅢNP), Laminin(LN) and Type Ⅳ Collagen(Ⅳ.C) by RIA. Meanwhile, prothrombin Time(PT) and platelet count were measured and so on. Results: The level of serum ACA was raised increasingly in different cirrhotic cases with different classifications of Child-Pugh, according to severity of the condition. There was a significant positive correlation between serum bilirubin and prothrombin time(PT) and ACA(P<0.01), and asignificant negative correlation between serum albumin and platelet count and ACA(P<0.01). There was no significant correlation bewteen serum ALT, AST, AST/ALT and bile acid with ACA (P≥0.05) and ALT,AST and AST/ALT had a significant effect on ACA (P<0.01),the most significant being AST/ALT. There was a significant positive correlationamong HA,PⅢNP,LN and Ⅳ.C, with ACA; among the above-mentioned four indices,only HA and PⅢNP had a significant effect on ACA (P<0.01),the most significant one being HA. Conclusion:The level of serum ACA in cases with hepatic cirrhosis was raised increasingly with the severity of the condition. CAC had some relationship with and effect on the three indices,i.e. the classification of Child-Pugh, regular hepatic functions and its fibrosizing. The ACC might have some clinical significance forcases with hepatic cirrhosis.
出处
《河北北方学院学报（医学版）》
2005年第1期12-16,共5页
Journal of Hebei North University:Medical Edition
