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目的 比较血清血小板衍生生长因子-BB(PDGF-BB)、转化生长因子-β_1(TGF-β_1),基质金属蛋白酶抑制剂-1(TIMP-1)、基质金属蛋白酶-1(MMP-1),透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(C-Ⅳ)和层黏连蛋白(LN)及外周血单个核细胞(PBMC)内TIMP-1 mRNA、MMP-1 mRNA在肝纤维化中的诊断价值。方法 常规肝穿活检、组织病理学诊断;RT-PCR检测PBMCs中MMP-1 mRNA、TIMP-1 mRNA水平;酶标法检测血清PDGF-BB、TGF-β_1、TIMP-1和MMP-1含量;放射免疫法检测血清HA、PCⅢ、C-Ⅳ和LN含量。结果 经ROC曲线分析,血清PDGF-BB、TIMP-1、HA、PCⅢ、C-Ⅳ、LN和TIMP-1 mRNA的AUC分别为0.985、0.726、0.318、0.728、0.727、0.583、0.463、0.876,血清PDGF-BB和PBMCs中TIMP-1 mRNA的灵敏度和特异度分别为90％,95％,73.7％、100％;两者联合检测的灵敏度为97.4％,特异度为95.0％。结论 八项指标中,血清PDGF-BB的诊断价值最大。在筛选肝纤维化患者时,以血清PDGF-BB、PBMC中TIMP-1 mRNA联合检测最佳。
Objective To compare the effects of serum platelet-derived growth factor-BB (B-PDGF-BB), transforming growth factor-β 1 (TGF- β 1), tissue inhibitor of metalloproteinase- 1 (TIMP-1), matrix metalloproteinase-1 The expressions of TIMP-1 mRNA and MMP-1 mRNA in HA, PCⅢ, C-Ⅳ and LN and PBMC In the diagnosis of liver fibrosis. Methods Normal liver biopsies and histopathological diagnosis were performed. The levels of MMP-1 mRNA and TIMP-1 mRNA in PBMCs were detected by RT-PCR. The levels of serum PDGF-BB, TGF-β 1, TIMP-1 and MMP- The contents of HA, PCⅢ, C-Ⅳ and LN in serum were detected by radioimmunoassay. Results The AUC of serum PDGF-BB, TIMP-1, HA, PCⅢ, C-Ⅳ, LN and TIMP-1 mRNA were 0.985,0.726,0.318,0.728,0.727,0.583,0.463,0.876 respectively by ROC curve analysis. The sensitivity and specificity of TIMP-1 mRNA in PDGF-BB and PBMCs were 90%, 95%, 73.7% and 100%, respectively. The sensitivity and specificity of the combined detection of PDGF-BB and PBMCs were 97.4% and 95.0% respectively. Conclusions Among the eight indexes, serum PDGF-BB has the highest diagnostic value. In screening patients with liver fibrosis, serum PDGF-BB, PBMC TIMP-1 mRNA combined detection of the best.