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目的 评价血清组织金属蛋白酶抑制因子诊断肝纤维化的应用价值。方法 本研究测定了 14 2例慢性病毒性肝炎病人的血清TIMP 1,并与血清生化指标、免疫学指标、影像学指标及肝活检组织学检查进行比较 ,以决定TIMP 1是否可作为慢性肝病肝纤维化诊断的一项有用的指标。结果 TIMP 1与ALT、AST、GGT、ALT、SB、HA、APOAI呈正相关 ,与白蛋白呈负相关 ,与PGA、PGAA积分无相关。与肝炎病毒标志 (HBsAg、抗 HBc、HBeAg、抗 HBe、HBVDNA、抗 HCV)无相关 ,与血脂 (TG、TC、高密度脂蛋白 ,低密度脂蛋白 )无相关 ,血清TIMP 1浓度与CD3、CD8、NK、IgG相关 (P <0 .0 5 )。将TIMP 1与B超指标作相关性分析 ,发现与胆囊壁厚度 ,脾脏厚度和胆囊形态相关 (P <0 .0 5 ) ;将TIMP 1与CT和MRI作相关性分析 ,发现与脾脏厚度相关 (P <0 .0 1) ;TIMP 1与肝组织学指标之间的相关分析可以看出TIMP 1与肝内炎症和纤维化均显著相关。利用判别分析法计算 ,以血清TIMP 1判别肝内炎症程度、纤维化的有无和肝硬化有无的准确性分别为 72 .5 4%、40 .85 %和 81.2 5 %。结论 血清TIMP 1水平反映了慢性肝病肝内炎症和纤维化的一些重要特征 ,在目前情况下是一种较好的肝纤维化无创伤性诊断和随访指标
Objective To evaluate the value of serum tissue metalloproteinase inhibitor in the diagnosis of liver fibrosis. Methods In this study, serum TIMP-1 was measured in 142 patients with chronic viral hepatitis and compared with serum biochemical, immunological, imaging and histological examination of liver biopsy to determine whether TIMP-1 could be used as a marker of chronic liver disease A useful indicator of diagnosis. Results TIMP 1 was positively correlated with ALT, AST, GGT, ALT, SB, HA, APOAI, negatively correlated with albumin, but not with PGA and PGAA. No correlation with hepatitis B virus markers (HBsAg, anti HBe, HBeAg, anti HBe, HBVDNA, anti-HCV), no correlation with serum lipids (TG, TC, HDL, LDL) CD8, NK, IgG (P <0.05). Correlation analysis of TIMP-1 and B super-index showed that it was correlated with gallbladder wall thickness, spleen thickness and gallbladder morphology (P <0.05). Correlation analysis between TIMP-1, CT and MRI showed that there was correlation between TIMP- (P <0.01). Correlation analysis between TIMP-1 and liver histology showed that TIMP-1 was significantly associated with intrahepatic inflammation and fibrosis. Discriminant analysis was used to determine the degree of intrahepatic inflammation, the presence or absence of fibrosis and the presence or absence of liver cirrhosis with serum TIMP 1 accuracy of 72.54%, 40.85% and 81.2%. Conclusions The level of serum TIMP-1 reflects some important features of intrahepatic inflammation and fibrosis in chronic liver disease, which is a good noninvasive diagnosis and follow-up of liver fibrosis in the current situation