晚期日本血吸虫病肝组织学与肝纤维化指标的相关性研究  

Study on relationship between liver tissue pathological changes and the fibrosis markers of serum in advanced schistosomiasis japonica

作　　者：朱剑君 黄令霞 陈栋良 宗道明 赵雅琴 赵晓贡 

机构地区：[1]湖南省血吸虫病防治研究所附属湘岳医院,岳阳414000

出　　处：《中国血吸虫病防治杂志》2007年第2期124-127,共4页Chinese Journal of Schistosomiasis Control

基　　金：湖南省卫生厅重点项目(A2004-2006)

摘　　要：目的探讨晚期血吸虫病(晚血)血清肝纤维化指标及其肝组织内的表达与肝纤维化检查的肝组织病理活检的相关程度。方法肝组织手术活检标本经10%甲醛固定,常规石蜡包埋切片,HE染色,光镜下病理学检查。肝组织基质金属蛋白酶-1(MMPS-1)、基质金属蛋白酶组织抑制因子-1(TIMPS-1)、转化生长因子-β1(TGF-β1)采用免疫组化染色S-P法。血清MMPS-1、TGF-β1检测采用酶联免疫吸附试验(ELISA)法,TIMPS-1检测采用免疫透射比浊法。结果共检测晚血脾切除患者45例。肝组织病理学检查按Scheuer分级S13例(6.0%)、S25例(11.1%)、S319例(42.2%)、S418例(40.0%)。肝组织免疫组化MMPS-1“+”27例(60.0%),“++”10例(22.2%),“+++”1例(2.2%);TIMPS-1“+”8例(17.8%),“++”18例(40.0%),“+++”13例(28.9%)。TGF-β1“+”8例(17%),“++”22例(48.9%),“+++”10例(22.2%)。血清MMPS-1、TIMPS-1、TGF-β1含量除MMPS-1外,均随肝纤维化程度加重和免疫组化阳性表达强度的增强而增高。结论晚血肝组织病理学检查肝纤维化程度的加重与肝组织TIMPS-1、TGF-β1免疫组化阳性表达强度及血清含量呈正相关;检测血清TIMPS-1、TGF-β1含量及TIMPS-1/MMPS-1比值是肝纤维化诊断和疗效评价较好的无创伤性指标。Objective To explore the relationship between the degrees of matrix metalloproteinases-1 （MMPS-1） ,tissue inhibitor of metal ioproteinases-1 （TIMPS-1）, transfer growing factor- β1（TGF-β1） in the liver tissue and serum and liver tissue pathologic biopsy in the patients with advanced schistosomiasis japonica. Methods The liver tissue biopsy samples were formalin-fixed, paraffin-embedded, HE-stained, and detected through scanning electro microscopy. The contents of MMPS-1 ,TIMPS-1 ,TGF-β1 in liver tissues were measured by the S-P irnmuno-histochemical staining method. MMPS-1 ,TGF-β1 in serum were measured by ELISA, and TIMPS-1 was measured by the immunoturbidimetric assay. Results Liver tissue pathologic biopsy showed S1 was 6.0%（3/ 45）, S2 11.1 % （5/45）, S3 42.2% （19/45）, S4 40.0% （18/45）. The immuno-histochemical detection showed positive MMPS-1 in liver tissues was 60. 0% （27/45 ,＂＋＂）, 22.20//00 （10/45 ,＂＋ ＋＂）, 2. 2% （1/45,＂＋ ＋＋＂）, the positive TIMPS-1 was 17.8%（8/45,＂＋＂）, 40.0%（18/45,＂＋＋＂）, 28.9% （13/45, ＂＋ ＋ ＋ ＂）, and the positive TGF-β1 was 17.8 %（8/45, ＂＋ ＂）, 48.9% （22/45, ＂＋ ＋ ＂）, 22.2%（10/45,＂＋ ＋ ＋＂）. The levels of MMPS-1,TIMPS-1, TGF-β1 in serum increasing as the increasing of hepatic fibrosis degrees and positive immuno-histochemical expression. Conclusions Theres is a correlation between hepatic fibrosis degree and TIMPS-1,TGF-β1 expression levels in liver tissue and in serum. The levels of TIMPS-1 and TGF-β1, and the ratio of TIMPS-1/TGF-β1 could be used as no-wounded markers for diagnosis and evaluation of therapeutic effect of hepatic fibrosis.

关 键 词：晚期血吸虫病 肝纤维化 肝组织学 免疫组织化学 

分 类 号：R532.21[医药卫生—内科学]