[血清金属蛋白酶与肝纤维化及炎症严重程度的关系]

[The relationship of serum metalloproteinase with the severity of liver fibrosis and inflammation].

作者信息

Yin Shan-shan, Li Xin-min, Wang Bao-en, Wang Tai-ling, Jia Ji-dong, Qian Lin-xue

机构信息

Beijing Friendship Hospital, Capital University of Medical Sciences, Beijing 100050, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2004 Nov;12(11):666-8.

PMID:15623375

Abstract

OBJECTIVE

To investigate the relationship of serum metalloproteinase with the severity of liver fibrosis and inflammation.

METHODS

A total of 88 patients with HBV-related liver fibrosis and early cirrhosis were enrolled from six hospitals. Serum fibrosis markers including hyaluronic acid (HA), IV collagen (IV-C), aminoterminal propeptide of type III procollagen (PIIIP), laminin (LN), matrix metalloproteinases (MMP) 1, 2, 9 and tissue inhibitors of metalloproteinase (TIMP) 1, 2 levels were determined. Liver biopsies were assessed according to a modified Scheuer and Chevallier's scoring system.

RESULTS

Serum TIMP1 (r=0.540) and MMP2 (r=0.314) were correlated positively with the degree of hepatic fibrosis, whereas serum MMP1 (r=-0.495) was correlated negatively. By receiver operating curve analysis (ROC), the sensitivity to distinguish the fibrosis stage 2 from stage 1 was 90.5% and the specificity was 52.0% if the cut-off value of MMP1 was 13.96 ng/ml, and the sensitivity was 91.6% and the specificity was 64.0% if the cut-off value of TIMP1 was 76.84 ng/ml. The sensitivity to distinguish cirrhosis (stage 4) from fibrosis (stage 3) was 70.7% and specificity was 80.9% if the cut-off value of MMP1 was 6.86 ng/ml, and the sensitivity was 60.5% and the specificity was 92.3% if the cut-off value of TIMP1 was 210.04 ng/ml.

CONCLUSION

Serum TIMP1, MMP1, MMP2 levels and TIMP1/MMP1 ratio could be used as serum fibrosis markers.

摘要

目的

研究血清金属蛋白酶与肝纤维化及炎症严重程度的关系。

方法

从六家医院招募了88例乙肝相关肝纤维化和早期肝硬化患者。检测血清纤维化标志物，包括透明质酸（HA）、IV型胶原（IV-C）、III型前胶原氨基端前肽（PIIIP）、层粘连蛋白（LN）、基质金属蛋白酶（MMP）1、2、9以及金属蛋白酶组织抑制剂（TIMP）1、2的水平。根据改良的Scheuer和Chevallier评分系统对肝活检进行评估。

结果

血清TIMP1（r = 0.540）和MMP2（r = 0.314）与肝纤维化程度呈正相关，而血清MMP1（r = -0.495）与肝纤维化程度呈负相关。通过受试者工作特征曲线分析（ROC），如果MMP1的截断值为13.96 ng/ml，区分纤维化2期和1期的敏感性为90.5%，特异性为52.0%；如果TIMP1的截断值为76.84 ng/ml，敏感性为91.6%，特异性为64.0%。如果MMP1的截断值为6.86 ng/ml，区分肝硬化（4期）和纤维化（3期）的敏感性为70.7%，特异性为80.9%；如果TIMP1的截断值为210.04 ng/ml，敏感性为60.5%，特异性为92.3%。