基质金属蛋白酶抑制剂-1在肝纤维化诊断中的临床应用(1)
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【摘要】 目的：评估血清基质金属蛋白酶抑制剂-1(TIMP-1)在肝纤维化诊断中的临床价值。方法：285例慢性乙型肝炎(CHB)患者，根据肝穿刺病理诊断结果分为无明显纤维化组(S0～S1)和明显纤维化组(S2～S4)。将病理诊断结果作为金标准，使用ROC曲线评估TIMP-1诊断肝纤维化的敏感度、特异性和符合率，并和肝纤维化标记物HA、PCⅢ、CⅣ、LN比较其诊断性能。结果：对照组、S0～S1组、S2～S4组TIMP-1血清浓度分别为(146.6±29.2)、(161.2±43.2)、(221.6±93.8)μg/L，对照组和S2～S4组及S0～S1组和S2～S4组间比较差异均有统计学意义(t分别为5.32、4.98，P<0.01)。TIMP-1区分慢性乙肝明显纤维化和轻度纤维化的ROC曲线下面积(AUC)为0.801(95%CI：0.762～0.940)，TIMP-1在临界值为170.3 μg/L时，其敏感度、特异度分别为88.5%、80.4%，高于HA(79.6%、72.5%)，PCⅢ(72.5%、78.5%)，CⅣ(63.6%、78.4%)和LN(78.5%、64.7%)。结论：血清TIMP-1诊断肝纤维化有较高的敏感度和特异性，血清TIMP-1可能是预测肝纤维化分期一个较好的指标。
【关键词】 基质金属蛋白酶抑制剂-1； 慢性乙型肝炎； 肝纤维化； 诊断； 酶联免疫吸附测定
Clinical Application of Tissue Inhibitor of Metalloproteinases-1 in Assessment of Liver Fibrosis/SHI Yu-ling.// Medical Innovation of China，2012，9(23):087-089
【Abstract】 Objective：To evaluate the clinical value of TIMP-1 for diagnosis liver fibrosis. Method: CHB patients were divided into mild liver fibrosis group (S0-S1) and significant liver fibrosis group (S2-S4)， according to pathological diagnosis. The diagnostic capacity of CTGF was assessed by comparing the area under receiver operating characteristic (AUC) with a panel of fibrosis markers.Result：Serum level of TIMP-1 in control group，S0-S1，S2-S4 was(146.6±29.2)，(161.2±43.2)，(221.6±93.8)μg/L，respectively. The level of TIMP-1 in S2-S4 group was significantly higher than that of S0-S1 group (t=5.32，P<0.01) and that of control group (t=4.98，P<0.01). The area ROC of TIMP-1 was 0.801 (95% confidence interval，0.762-0.940) in distinguishing mild fibrosis from significant fibrosis， which was highest among five markers. When cutoff value of TIMP-1 is 170.3μg/L，the sensitivity and specification is 88.5%，80.4 %，which were higher than that of HA(79 ......
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