肝硬化患者血清基质金属蛋白酶-2检测的临床意义.docVIP

肝硬化患者血清基质金属蛋白酶-2检测的临床意义 【摘要】 目的 了解基质金属蛋白酶-2(MMP-2)在肝纤维化形成中的作用及与肝硬化患者肝功能损害程度的关系。 方法 采用酶联免疫吸附(ELISA)方法检测了52例肝炎后肝硬化患者和28例慢性肝炎患者(对照组)血清MMP-2浓度。结果 肝硬化组MMP-2显著高于对照组(P＜0.01、)；但是肝硬化患者血清中MMP-2浓度随Child-Pugh分级增高显著下降，A、B、C级之间差异均有统计学意义(P均＜0.01)，MMP-2水平A＞B＞C。同时发现纤维化指标透明质酸(HA)浓度亦高于对照组(P＜0.01)，随Child-Pugh分级增高显著上升，A、B、C级之间差异均有统计学意义，HA水平呈C＞B＞A。结论 肝硬化患者血清MMP-2水平和HA明显升高，且血清中MMP-2水平和HA与肝功能分级明显相关，表明MMP-2与肝纤维化程度有关。HA是与肝病严重程度相关的一个参数。 【关键词】 肝硬化；基质金属蛋白酶；透明质酸 　　Abstract: Objective To explore the effect of serumal MMP-2 on hepatic-injury and the relation between serverity of hepatic-injury and the pathogenesis of fiberosis. Methods Using ELISA,the serum concentration of MMP-2 and HA were examined in 52 cirrhosis cases with a history of hepatitis(study group) and in 28 controls with chronic viral hepatitis. Results The serum level of MMP-2 in study group was significantly higher than that of controls (P＜0.01). The more critical by classification of Child-pugh, the lower serumal MMP-2 level (A grade vs B grade, B grade vs C grade,C grade vs A grade；P＜0.01, P＜0.01, and P＜0.01, respectively). Hyaluronic acid(HA), Unlike that of MMP-2, As the Child-Pugh classification increases , the serum level of HA in patients was significantly higher than that of the control group(C＞B＞A, P＜0.01). Conclusion Serum concentration of MMP-2 may become an important parameter for predicting the development of liver fibrosis. It may positively contribute to the precise evaluation of fibrosis stage. HA can be a index for showing the severity of live diseases. 　　Key words： cirrhosis after hepatitis；matrix metalloprotease；HA 肝硬化发病机制复杂。国内外大量的基础 研究 和临床研究工作表明，肝硬化形成的关键环节是肝细胞损伤后的纤维化过程。肝硬化是细胞外基质产生和降解不平衡的结果，基质金属蛋白酶-2(MMP-2)参与降解细胞外基质；其与肝纤维化形成的关系，已有一些报道［1-2］。为进一步了解血清MMP-2在肝纤维化形成中的作用以及与肝硬化患者肝功能损害程度的关系，本文采用双抗体“夹心”酶联免疫吸附(ELISA)方法，检测了52例肝炎后肝硬化患者血清中MMP-2和透明质酸(HA)浓度，探讨其在肝硬化形成中的作用。 　　1 材料与方法 　　1.1 对象及分组 选择我院2005年6月—12月收治并确诊为病毒性肝炎后肝硬化的住院病人52例作为肝硬化组；28例慢性肝炎患者作为对照组。全部病例均排除肝占位性疾病、结缔组织病、血液系统病、慢性肾脏疾病、代谢性疾病、糖尿病等内分泌系统疾病以及其它炎性疾病。 肝硬化组：52例中