血清TIMP-1、M-CSF联合检测对老年病人乙型肝炎后肝硬化早期诊断的价值

Value of serum TIMP-1 and M-CSF levels in early diagnosis of post-hepatitis B cirrhosis in elderly patients

目的探讨血清基质金属蛋白酶抑制因子-1(TIMP-1)、巨噬细胞集落刺激因子(M-CSF)水平对老年病人乙型肝炎后肝硬化早期诊断的价值。方法回顾性纳入2020年3月至2022年5月医院收治的97例老年乙型肝炎后肝硬化病人为研究组,另回顾性纳入医院同时间段收治的125例老年乙型肝炎病人为对照组。根据病人肝硬化程度将研究组分为肝硬化A级39例、肝硬化B级33例、肝硬化C级25例。比较各组间血清TIMP-1、M-CSF水平的差异,分析血清TIMP-1水平与血清M-CSF水平的相关性,分析老年乙型肝炎病人发生肝硬化的影响因素,分析血清TIMP-1、M-CSF联合检测对老年乙型肝炎病人发生肝硬化的诊断价值。结果研究组总胆红素(TBIL)、甲胎蛋白(AFP)水平高于对照组,凝血酶原时间(PT)长于对照组(P<0.01),白蛋白(ALB)水平低于对照组(P<0.01);研究组血清TIMP-1、M-CSF水平高于对照组(P<0.01);血清TIMP-1、M-CSF水平随着肝硬化程度加重而逐渐升高(P<0.05);血清TIMP-1水平与血清M-CSF水平呈正相关(P<0.05)。血清TBIL、TIMP-1、M-CSF、ALB及PT为老年乙型肝炎病人发生肝硬化的影响因素(P<0.05)。血清TIMP-1、M-CSF水平及二者联合诊断老年乙型肝炎病人发生肝硬化的AUC分别为0.821、0.813、0.896(P<0.05),且二者联合诊断价值更高(P<0.05)。结论血清TIMP-1、M-CSF水平在早期诊断老年病人乙型肝炎后肝硬化中具有重要价值,且二者联合具有更高的诊断价值。

Objective To investigate the value of serum tissue inhibitors of metalloproteinase-1(TIMP-1)and macrophage colony-stimulating factor(M-CSF)levels in the early diagnosis of post-hepatitis B cirrhosis in the elderly patients.Methods A total of 97 elderly patients with post-hepatitis B cirrhosis admitted to our hospital from March 2020 to May 2022 were enrolled as the study group,and 125 elderly patients with hepatitis B during the same period were enrolled as the control group.According to the degree of cirrhosis,the study group was divided into 39 patients with grade A cirrhosis,33 patients with grade B cirrhosis and 25 patients with grade C cirrhosis.The serum TIMP-1 and M-CSF levels were compared between the two groups and the patients with different grades of cirrhosis,and the correlation between serum TIMP-1 level and serum M-CSF level was analyzed.The influencing factors of cirrhosis in the elderly patients with hepatitis B were analyzed,and the diagnostic value of serum TIMP-1 and M-CSF levels for post-hepatitis B cirrhosis in the elderly patients was analyzed.Results The levels of total bilirubin(TBIL),alpha-fetoprotein(AFP)and prothrombin time(PT)in the study group were higher than those in the control group(P<0.01),and the level of albumin(ALB)was lower than that in the control group(P<0.01).The levels of TIMP-1 and M-CSF in the study group were higher than those in the control group(P<0.01).The serum levels of TIMP-1 and M-CSF in the patients with grade C cirrhosis were highest,followed by grade B and grade A(P<0.05).Serum TIMP-1 level was positively correlated with serum M-CSF level(P<0.05).Logistic regression analysis showed that TBIL,PT,TIMP-1,M-CSF and ALB were the influencing factors for cirrhosis in the elderly patients with hepatitis B(P<0.05).The area under the curve(AUC)of serum TIMP-1,M-CSF and combination in diagnosing liver cirrhosis in the elderly patients with hepatitis B was 0.821,0.813 and 0.896,respectively(P<0.05),and the AUC of combination of TIMP-1 and M-CSF was higher(P<0.05).Conclusions Serum TIMP-1 and M-CSF levels have important value in early diagnosis of post-hepatitis B cirrhosis in the elderly patients,and their combination has higher diagnostic value.