A 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.
【KEY WORDS】 anticardiolipin antibody; hepatic cirrhosis; clinical significance
本研究用ELISA法测定了Child-Pugh分级下的肝硬化患者血清抗心磷脂抗体(ACA，包括IgG、IgM、IgA)的含量，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，旨在探讨肝硬化患者血清中ACA含量的变化及其与肝功能受损程度及肝纤维化等相关指标间的联系与影响。
1 临床资料
1.1 一般资料 对2001.10～2002.5月复旦大学华山医院消化科的96例肝炎后肝硬化住院患者进行了前瞻性研究，其中，男77例，女19例，男∶女=4.05∶1;年龄范围36～62岁，平均年龄(49±6.37)岁，年龄、发病高峰与性别构成比基本与肝硬化流行病学相符[1]。按Child-Pugh等级分类，A级25例(男18例，女7例)，B级48例(男38例，女10例)，C级 23例(男21例，女2例)分成三组，A、B、C各级例数构成比分别是26%，50%和 24%，服从正态分布。
1.2 抗心磷脂抗体(ACA)的检测方法与阳性判定 ACA(IgG、IgM、IgA)检测试剂盒由上海德波生物技术有限公司提供，采用ELISA方法，操作步骤严格按说明书要求进行。用酶标仪在490nm波长读取吸光值(A)，ACA结合指数(BI)按下式计算：
结合指数(BI)=标本吸光值(A)-空白吸光值(A)正常吸光值(A)-空白吸光值(A)
正常参考值ACA结合指数(BI)小于2.2，判定标准以IgG、IgM、IgA三者中只要有一项(B
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