摘要 目的：研究慢性乙肝(CHB)患者血清透明质酸(HA)、激活素A(ACTA)、肿瘤坏死因子-α(TNF-α)含量与肝组织炎症活动及纤维化程度的关系。方法：采用酶联免疫吸附试验(ELISA)和放射免疫吸附试验(RIA)测定96例慢性乙肝患者血清HA、ACTA、TNF-α含量，同时进行肝组织活检，对肝组织进行炎症分级及纤维化分期，分析以上三项指标与肝组织病理变化的关系。结果：慢性乙肝患者血清HA、ACTA、TNF-α含量与慢性乙肝发展阶段性相一致，在慢性乙肝重度与肝硬化(LC)阶段达最高水平。与肝组织炎症及纤维化程度一致，在纤维化分期S4处于最高水平。结论：血清HA、ACTA、TNF-α与肝纤维化的发病机制密切相关，检测血清以上三项指标对于肝纤维化动态观察、早期诊断及预后评估具有一定的理论和临床价值。

    关键词 透明质酸；激活素A；肿瘤坏死因子-α；肝纤维化

    Relationship between the Level of Serum HA,ACTA,TNF-α and the Pathological Changes of the Liver Tissue in Patients with Chronic Hepatitis

    YANG Qing, BAI Jing, WANG Xingyun, LIU Zhonghui

    (The First Affiliated Hospital,Jilin University, Changchun 130021,China)

    Abstract Objective:To study the relationship between the serum hyaluronic acid(HA),activinA (ACTA),tumour necrosis factor-α(TNF-α)and the inflammatory reaction ,pathological changes of the liver tissue in patients with chronic hepatitis.Methods: the serum HA,ACTA,TNF-αcontent was assayed by Elisa and RIA in 96 cases of chronic hepatitis B, and liver biopsy,inflammation classification and fibrosis stage division were carried out at the same time ,then the relationship between the three indexes above and the pathological changes of the liver tissue was analysed. Results:The level of the serum HA, ACTA ,TNF-α in patients with chronic hepatitis B was consistent with its development stages, which reached the highest level at the severe stage of chronic hepatitis B and in liver cirrhosis .They were also consistent with the level of liver tissue inflammation and fibrosis,manifesting the highest level in inflammation fobrosis stage S4. Conclusion: The serum HA,ACTA,TNF-αare closely correlate to the pathogenesis of the hepahepatic fibrosis.The three index above is of some theoretic and clinical significance in the dynamic observation of liver fibrosis,the earlyβdiagnosis, therapy and the estimate of the prognosis. ......