الفهرس 
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Abstract
Chronic liver diseases, CLD, are a major cause of morbidity and mortality in the present day world. Chronic infections with hepatitis B and C viruses, alcoholic and non-alcoholic fatty liver diseases are important causes of CLD. The major determinant in their prognosis is the progressive accumulation of fibrosis, with distortion of the hepatic architecture, and ultimate progression to cirrhosis and its allied complications.Liver fibrosis is defined by excessive non-specific accumulation of altered extracellular matrix (ECM). Fibrosis leading to cirrhosis can accompany any CLD that is characterized by the presence of hepatobiliary inflammation. The process of fibrogenesis itself is usually divided into 2 parts initiation and perpetuation. Fibrosis markers can be divided into direct and indirect where direct markers reflect extracellular matrix (ECM) metabolism and Indirect markers reflect alterations in hepatic function but do not directly reflect extracellular matrix (ECM) metabolism.
The present study was carried out to estimate hylauronic acid level and Chondrex (YKL-40) level as noninvasive fibrotic markers in patients with liver fibrosis in corresponding to the degree of fibrosis. This study was included Seventy-five patients with chronic liver disease, Fibrosis, and fifteen healthy control subjects where Subjects were divided into: Group 1 Control group included 15 healthy volunteers. Group 2: Included 25 mild liver fibrosis patients. Group 3: Included 25 modrate liver fibrosis patients and Group 4: Included 25 severe liver fibrosis patients. The results of our study showed that there were significant increase in AST, ALT, ALP and GGT activities from mild to moderate to severe fibrosis. There were highly significant increase in serum AST ALT, ALP and GGT activities in the fibrotic group with the different stages when compared to control group also there were significant increase in serum Total bilirubin in the fibrotic group with the different stages when compared to control group.
There were significant decrease in Serum albumin level, total protein concentration, PC and Platelets count from mild to moderate to severe fibrosis. There were highly significant decrease in serum albumin level and total protein concentration in the fibrotic group with the different stages when compared to control group.
Our study showed that there was a significant increase in the level of both hyaluronic acid (HA) and YKL-40 in fibrotic group compared to control also there were a significant increase in the level of hyaluronic acid and YKL-40 from mild to moderate to severe stage of fibrosis. It could be concluded that both of HA and YKL-40 could be helpful in diagnosing liver fibrosis and its degree.