慢性肝病患者血清MMP-13,TIMP-1和相关指标的检测及其临床应用价值分析  

Clinical Value of Detecting Serum MMP-13,TIMP-1 and Related Indexes of Liver Fibrosis Levels in Patients with Chronic Liver Disease

作　　者：黄书明[1] 张建忠[2] 包海燕[2] 朱建云[2] 邵玲玲[2] 刘群德[2] 徐燃[2] 钱引坤 

机构地区：[1]南通市第三人民医院,江苏南通226001 [2]如东县人民医院,江苏如东226400

出　　处：《现代检验医学杂志》2013年第1期34-37,共4页Journal of Modern Laboratory Medicine

基　　金：南通市社会发展科技计划项目（S10937）.

摘　　要：目的 探讨慢性肝病患者血清中基质金属蛋白酶-13（matrix metalloproteinase-13,MMP-13）及金属蛋白酶组织抑制物-1（tissue inhibitor of metalloproteinase-1,TIMP-1）的水平与相关肝纤维化指标的关系及其临床应用价值.方法 选择66例慢性乙型肝炎（chronic hepatitis B,CHB）患者、76例肝硬化患者（liver cirrhosis,LC）和60例健康体检者作为研究对象,采用ELISA法检测其血清中MMP-13和TIMP-1的水平,采用放射免疫法检测血清中透明质酸（HA）、层黏连蛋白（LN）、Ⅲ型前胶原蛋白（PCⅢ）和Ⅳ型胶原（CⅣ） 的水平,观察MMP-13,TIMP-1与相关肝纤维化指标的关系及临床动态变化.结果 CHB和LC组中血清MMP-13,TIMP-1,HA,LN,PCⅢ和Ⅳ-C水平明显高于正常对照组,差异有统计学意义（P〈0.01）;LC组中患者血清MMP-13和TIMP-1,HA,LN,PCⅢ和Ⅳ-C的水平高于CHB组,差异有统计学意义（P〈0.01）;随着慢性肝病的进展TIMP-1的升高幅度高于MMP-13,MMP-13/TIMP-1比值逐渐下降;CHB和LC组中患者血清MMP-13和TIMP-1的水平与其HA,LN,PCⅢ和Ⅳ-C呈明显正相关（r值分别为0.827,0.756,0.813,0.642和0.905,0.829,0.887,0.918,P均〈0.01）.结论 血清MMP-13和TIMP-1的水平与慢性肝病的病情进展呈正相关,而MMP-13/TIMP-1比值与慢性肝病的病情进展呈负相关,因此MMP-13和TIMP-1的血清水平及其两者的比值可作为判断慢性肝病纤维化程度的观察指标.Objective To investigate the clinical value of detecting serum matrix metalloproteinase-13（MMP-13） ,tissue inhibitor of metalloproteinase-1 （TIMP-1） and its relationship to related indexes of hepatic fibrosis in patients with Chronic liver disease. Methods Choiced 66 patients with CHB,76 patients with LC,and 60 healthy persons as the research objects and used the EL1SA method for detecting the serum MMP-13 and TIMP-1 levels and the radioimmunoassay method for detecting of serum hyaluronic acid （HA）,laminin （LN） ,type Ⅲprocollagen （PC Ⅲ ） and collagen type Ⅳ （IV-C） level,observed the relationship of MMP-13 and TIMP-1 and liver fibrosis indexes and their clinicaldynamic change. Results The serum MMP- 13,TIMP-1, HA,LN,PCⅢ and Ⅳ-C concentrations in all patients with CHB or LC were significantly higher than those in normal control,and their concentrations in all patients with LC were also significantly higher than those in the patients CHB. With the progression of chronic liver diseases the increase rate of TIMP-1 was higher than MMP-13 and MMP-13/ TIMP-1 ratio gradually decreased. The serum MMP-13 and TIMP-1 levels were positively related to the levels of the serum HA,LN,PCⅢ and Ⅳ-C. Conclusion The serum MMP-13 and TIMP-1 levels in patients with chronic liver disease were positively correlated to the progression of chronic liver diseases,but the ratio of MMP-13/TIMP-1 were negatively correlated. So MMP-13,TIMP-1 levels and their ratios can be used as observation indexes of judging the degree of chronic hepatic fibrosis.

关 键 词：基质金属蛋白酶-13 金属蛋白酶组织抑制物-1 慢性乙型肝炎 肝硬化 

分 类 号：R575[医药卫生—消化系统] R392.11[医药卫生—内科学]