肝病患者血清中TIMP-1与HA、PCⅢ、CⅣ、LN水平的相关性

Relationships between the TIMP-1 and the level of HA,PCⅢ,CⅣ and LN in the serum of hepatitis patients

目的了解肝病患者血清中基质金属蛋白酶组织抑制物-1(TIMP-1)与透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)和层粘连蛋白(LN)的相互关系及临床意义。方法425例肝病患者和110例正常对照者采用双抗体夹心酶联免疫吸附方法(ELISA)测定血清TIMP-1,放射免疫分析法测定HA、PCⅢ、CⅣ和LN和全自动酶法测定血清总胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)。结果与健康正常人对照比较,肝病患者五项指标均有不同程度的升高,除慢性肝炎轻度组CⅣ含量水平与对照组无统计学意义外,其余各组均与对照组有显著性差异(P<0.01)。其中唯有TIMP-1血清含量水平从急性肝炎至肝硬化依次进行性升高,慢性肝炎轻度组与急性肝炎组相比,t=2.603,P<0.01。血清TIMP-1与HA、PCⅢ、CⅣ和LN呈显著正相关(P<0.01),与TBA、ALT呈正相关(P<0.05),并随肝脏病损纤维化程度加重而检出阳性率逐渐增高(P<0.005)。结论五项指标均可不同程度的反映肝脏的纤维化程度,其中以血清TIMP-1更为可靠、有效。

Objective To explore the relationships and significance among the tissue inhibitor of metalloproteinases-1 （T IMP-1 ）, hyaluronia acid（ HA）, procollagen type Ⅲ （PC Ⅲ ）, procollagen type Ⅳ （CⅣ） and laminin（LN） in the serum of hepatitis patients. Methods The serum TIMP-1 were detected with enzyme - linked immunosorbent assay （ELISA）, the serum TBA and ALT levels were measured with totally automatic enzymatic method, and the other markers with RIA in 425 hepatitis patients as well as in 110 healthy controls. Results Serum levels of the markers were higher in the patients than those in the healthy controls, and had significant difference（ P 〈 0.01 ）, except the C Ⅳ level of mild chronic hepatitis. Among the various types of hepatitis, only the serum TIMP-1 level constantly increased from acute hepatitis to liver cirrhosis, and difference was found between mild chronic hepatitis and acute hepatitis（ t = 2. 603, P 〈 0.01 ）. There were positive correlations between serum TIMP-1 and HA, PC Ⅲ , CⅣ, LN,TBA, ALT, and the severer the hepatic fibrosis in the injured liver was, the higher the positive ratio of TIMP-1 was. Conclusion These five markers may reflect the state of liver fibrosis in different liver diseases, and the serum TIMP-1 may be more reliable for diagnosis of liver fibrosis.