非酒精性脂肪性肝病儿童血清TIMP-1和TIMP-2检测及临床意义

目的：了解非酒精性脂肪性肝病患儿基质金属蛋白酶组织抑制物（TIMP）-1和TIMP-2的水平及价值。方法根据诊断标准将105例肥胖儿童分为单纯性肥胖（n=44）、单纯性非酒精性脂肪肝（SNAFL，n=25）和非酒精性脂肪肝炎（NASH，n=36）3组，采用酶联免疫吸附方法(ELISA)测定血清TIMP-1、TIMP-2，全自动酶法测定丙氨酸氨基转移酶(ALT)和γ-谷氨酸转肽酶(γ-GT)。结果随着单纯性肥胖向SNAFL和NASH发展，TIMP-1和γ-GT水平逐步升高，差异有统计学意义(P0.05)。结论 血清TIMP-1和TIMP-2指标均可不同程度地反映肝脏的纤维化程度，其中以TIMP-1更为可靠、有效。［中国当代儿科杂志，2010，12（6）：455-458］

Determination and clinical significance of tissue inhibitors of metalloproteinase-1 and -2 in serum of children with nonalcoholic fatty liver disease

Objective To examine serum tissue inhibitors of metalloproteinases(TIMP)-1 and-2 levels in children with nonalcoholic fatty liver disease and to investigate possible roles of the two markers.Methods One hundred and five obese children were classified into 4 groups:simple obesity(n=44),simple nonalcoholic fatty liver(SNAFL,n=25),and nonalcoholic steatohepatitis(NASH,n=36).Serum TIMP-1 and-2 levels were measured using ELISA.Serum ALT and γ-GT levels were measured with totally automatic enzymatic method.Results Serum levels of TIMP-1 and γ-GT increased with the disease development from simple obesity to SNAFL and NASH(P<0.05).Both serum TIMP-1 and-2 levels were positively correlated with γ-GT levels(r=0.534,P<0.01;r=0.351,P<0.05,respectively).Ninety-seven percent of children in the NASH group had serum TIMP-1 levels over 2 standard deviations of healthy controls(83.35 μg/ L)compared with 76% in the SNAFL group(P﹤0.05).There were no significant differences in the case proportion with TIMP-2 levels over 2 standard deviations of healthy controls between the NASH and the SNAFL groups.Conclusions Both TIMP-1 and-2 may reflect the state of liver fibrosis in children with nonalcoholic fatty liver disease,and serum TIMP-1 appears to be more reliable.