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目的 建立一种改良固相致敏红细胞吸附技术 (SPASE) ,用于快速检测各种肝病患者血清中金属蛋白酶组织抑制因子 1 , 2 (TIMP 1 ,TIMP 2 ) ,了解血清TIMP 1和TIMP 2在各种肝病患者中的意义。方法 用TIMP 1和TIMP 2单克隆抗体分别包被微量血凝板 ,加热冲洗后加入待检血清标本 ,最后加入单克隆抗体致敏红细胞。用致敏红细胞作为指示系统 ,观察红细胞吸附状况来判定结果。结果 SPASE法全过程仅需要 2 5～ 3h ,共检测 6 5 4例肝病患者血清标本 ,TIMP 1和TIMP 2阳性率分别为急性肝炎组 1 7 3 9%、1 4 1 3 % ;慢性肝炎组 3 3 1 9%、2 7 88% ;肝硬化组 82 84%、6 7 1 6 % (P <0 0 0 1 )。结论 TIMP 1和TIMP 2表达的变化可作为肝纤维化较为有用的诊断指标 ,TIMP 1的诊断意义更大。SPASE法具有较高的敏感性、特异性和快速性 ,不需复杂的仪器设备 ,操作简单 ,尤适于医院及基层医疗单位。
OBJECTIVE: To establish a modified solid phase sensitized erythrocyte adsorption technique (SPASE) for the rapid detection of serum TIMP-1, TIMP-2 and TIMP-1 in various liver diseases. The significance of a variety of liver disease patients. Methods Monoclonal antibodies against TIMP-1 and TIMP-2 were respectively coated on a small amount of hemagglutination plate, heated and rinsed to add serum samples to be tested, and finally, monoclonal antibodies were added to sensitize erythrocytes. With sensitized erythrocytes as an indicator system, observe the status of erythrocyte adsorption to determine the results. Results Serum samples of 654 patients with liver disease were detected in the whole course of SPASE method only for 2 ~ 3 hours. The positive rates of TIMP-1 and TIMP-2 in patients with chronic hepatitis were 17.39% and 14.3% respectively in acute hepatitis group and chronic hepatitis group 3 3 1 9%, 2 7 88%; liver cirrhosis 82 84%, 6 7 1 6% (P 0 001). Conclusion The changes of TIMP-1 and TIMP-2 expression may be useful as diagnostic indicators of liver fibrosis, and TIMP-1 is of greater diagnostic value. SPASE method with high sensitivity, specificity and speed, without complex equipment, simple operation, especially for hospitals and primary care units.