血清TIMP-2水平对肝纤维化诊断价值的研究

目的评价HBV感染者血清TIMP-2水平对肝纤维化诊断的临床应用价值。方法采用ELISA法测定498例HBV感染者和100例正常对照者血清TIMP-2,采用放射免疫分析法检测HA、PCⅢ、CⅣ和LN,和采用全自动酶法测定丙氨酸氨基转移酶（ALT）。结果与健康正常人比,HBV感染者五项指标均有不同程度的升高,除慢性HBV携带者PCⅢ、CⅣ、LN、ALT和慢性肝炎轻度患者CⅣ水平与对照组比无统计学差异外,其余各组均与对照组比有显著性差异（P〈0.05）;从急性肝炎至肝硬化患者血清TIMP-2水平依次进行性升高,其中慢性HBV携带者与急性肝炎患者血清TIMP-2水平分别为78.56±26.23ng/ml和92.65±21.93ng/ml,两者相比差异显著（P〈0.01）。血清TIMP-2与HA、PCⅢ、CⅣ和LN呈显著正相关（P〈0.05）,与ALT也呈正相关（P〈0.05）。结论本文检测的肝纤维化指标均可不同程度地反映肝脏的纤维化程度,其中以血清TIMP-2较为可靠和有效。

The serum level of TIMP-2 in diagnosing hepatic fibrosis in patients with hepatitis B viral infection

Objective To evaluate the clinical value of serum level of TIMP-2 in the diagnosis of hepatic fibrosis in patients with HBV infection. Methods The serum TIMP-2 were detected with enzyme -linked immunosorbent assay, the serum ALT levels were measured with totally automatic enzymatic method,and the other markers with RIA in 498 hepatitis patients as well as in 100 healthy controls. Results Serum levels of the markers were higher in patients with HBV infecion than those in healthy controls,except the PCⅢ,CⅣ,LN and ALT level in patients with chronic HBV carrier and the CIV level in with mild chronic hepatitis B. Among the various types of patients with HBV infection,only the serum TIMP-2 level constantly increased from acute hepatitis to liver cirrhosis,and the difference was found between patients with chronic HBV carrier （78.56±26.23ng/ml）and acute hepatitis B （92.65±21.93ng/ml,P〈0.05）.There were positive correlations between serum TIMP-2 and HA,PCⅢ,CⅣ,LN and ALT （P〈0.05）. Conclusion These markers may reflect the state of liver fibrosis in different liver diseases,and the serum TIMP-2 may be more reliable for diagnosis of liver fibrosis.