七项肝纤维化血清标志物的诊断意义  

Diagnostic significance of seven serum indices for hepatic fibrosis

作　　者：万蕾[1] 徐建英[2] 叶晓光[1] 

机构地区：[1]广州医学院第二附属医院感染病科,510260 [2]广州医学院第二附属医院检验科,510260

出　　处：《中华生物医学工程杂志》2007年第5期326-328,共3页Chinese Journal of Biomedical Engineering

摘　　要：目的检测肝病患者血清基质金属蛋白酶1（MMP—1）、基质金属蛋白酶抑制剂l（TIMP—1）、转化生长因子B1（TGF—B1）、透明质酸（HA）、Ⅲ型前胶原（PⅢP）、IV型胶原（cⅣ）和层粘连蛋白（LN）含量，评价其对肝纤维化的诊断价值。方法酶标法检测血清MMP—1、TIMP—1、TGF—β1含量。放射免疫法检测血清HA、PiⅢ、CⅣ、LN含量。结果肝病患者血清TGF—β1、HA、PⅢP、CⅣ、LN水平与健康对照组比较均有升高，差异均有统计学意义（P〈0．05）。慢性肝病患者血清TIMP—1水平明显高于健康对照组（P〈0．01），而肝病患者血清MMP—1水平与健康对照组比较，差异无统计学意义（P〉0．05）。结论慢性肝病患者存在MMP—1和TIMP—1的严重失衡，是慢性肝病患者肝脏细胞外基质沉积的重要原因。血清TIMP—1、TGF—β1、HA、PⅢP、CⅣ和LN对肝纤维化具有较好的临床诊断价值，而MMP—1的临床诊断价值欠佳。Objective To evaluate the clinical value of serum matrix metalloproteinase-1 （ MMP-1 ） , tissue inhibitor of matrix metalloproteinase-1 （ TIMP-1 ）, transforming growth factor-β1 （ TGF-β1 ）, hyaluronic acid（ HA ）, type IU procollagen （ PⅢ P）, Ⅳ collagen （ C Ⅳ） and laminin （ LN ） in the diagnosis of hepatic fibrosis. Methods Serum samples from 20 cases of acute hepatitis,40 cases of chronic hepatitis,40 cases of liver chirrosis,30 cases of hepatocyte carcinoma and 25 healthy blood donors were assayed for serum levels of MMP-1 ,TIMP-1 ,TGF-β1 with ELISA and for serum levels of HA, P Ⅲ P, CⅣ, LN with RIA. Results Compared with the healthy controls the serum levels of TGF-β1, HA, P Ⅲ P, C Ⅳ, LN of the patients with liver disease were significantly higher. The serum levels of TIMP-1 of the patients with chronic liver disease were obviously higher than that of healthy controls. No significant changes of surum MMP-1 could be found in patients with liver disease. Conclusions There is altered balance between MMP-1 and TIMP-1 in patients with chronic liver disease,which may be the important season for the accumulation of extracellular matrix in the livers of these patients. Serum TIMP-1, TGF-β1, HA, PⅢ P, C Ⅳ and LN are more efficient to screen hepatitis fibroses but the diagnostic value of serum MMP-1 for hepatic fibrosis is not good.

关 键 词：肝纤维化 金属蛋白酶类 转化生长因子Β1 透明质酸 

分 类 号：R575[医药卫生—消化系统] R446[医药卫生—内科学]