慢性肝病患者血清MMP-3、TIMP-1水平在肝纤维化进程中的临床意义

目的 观察慢性乙型肝炎后肝病患者血清MMP-3、TIMP-1水平变化,探讨其在慢性肝病肝纤维化进程中的临床意义.方法 采用ELISA方法检测25例慢性乙型肝炎患者、53例乙型肝炎后肝硬化患者、31例肝癌患者及27例正常对照者血清MMP-3、TIMP-1水平.结果 与正常对照组比较,肝硬化代偿期患者血清MMP-3水平明显增高（P〈0.01）,肝硬化失代偿期患者和肝癌患者血清TIMP-1水平及TIMP-1/MMP-3比值明显增高（P〈0.05）;慢性乙型肝炎MMP-3、TIMP-1水平及TIMP-1/MMP-3比值均升高（P〈0.01）.肝硬化失代偿期与代偿期比较,血清MMP-3水平明显下降,TIMP-1/MMP-3比值则明显增高（P〈0.01）.结论 TIMP-1、MMP-3作为对肝纤维化评价的血清指标,联合检测比单独检测TIMP-1更具实用价值.TIMP-1、MMP-3在临床上对肝纤维化的监测和治疗效果的评价具有无损伤及快速便捷的优势,动态检测可作为评估慢性肝病患者肝纤维化进程及治疗效果的有效指标.

Relationship of hepatic fibrosis with serum MMP-3 and TIMP-1 in patients with chronic hepatopathy

Objective To investigate the clinical significance of serum MMP-3 and TIMP-1 in patients with chronic hepatopathy. Methods Serum MMP-3 and TIMP-1 levels were measured by ELISA method in 25 cases of chronic hepatitis, 53 cases of posthepatitis cirrhosis, 31 cases of hepatocellular carcinoma and 27 healthy individuals. Results Serum MMP-3 in patients with compensated hepatic cirrhosis was significantly higher than that in healthy controls （P〈0.01） ; serum TIMP-1 and the ratio of TIMP-1/ MMP-3 in patients with decompensated hepatic cirrhosis and in patients with hepatocellular carcinoma were significantly higher than those in healthy controls （P〈0.05）; the serum levels of MMP-3, TIMP-1 and ratio of TIMP-/MMP-3 in patients with chronic hepatitis B were significant higher than those in healthy controls （P〈0.01）. The serum level of MMP-3 in patients with decompensated hepatic cirrhosis was lower, the ratio of TIMP-1/ MMP-3 was higher than those in patients with compensated hepatic cirrhosis （P〈0.01）. Conclusion The combined detection of TIMP-1 and MMP-3 is of value in monitoring hepatic fibrosis in patients with chronic hepatopathy.