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目的:探讨乙型肝炎后肝硬化和肝癌患者血浆基质金属蛋白酶3(MMP-3)、基质金属蛋白酶抑制剂-1(TIMP-1)、尿激酶型纤溶酶原激活物(u-PA)及其受体(u-PAR)的水平变化及其临床意义。方法:应用酶联免疫吸附试验(ELISA)测定血浆MMP-3、TIMP-1、uPA和u-PAR的水平。结果:①与正常对照组比较,肝硬化患者代偿期组血浆MMP-3和u-PAR水平升高,差别有显著性(P<0.01);肝硬化患者失代偿期组血浆u-PA、u-PAR、TIMP-1水平和TIMP-1/MMP-3比值均明显升高,差异有显著性(P<0.01和P<0.05);肝癌患者血浆u-PA和u-PAR水平显著升高(P<0.01),约是对照组的两倍,TIMP-1和TIMP-1/MMP-3比值水平亦明显升高,差异有显著性(P<0.01)。②肝硬化患者失代偿期组与代偿期组比较血浆u-PA、u-PAR和MMP-3水平均明显增高,TIMP-1/MMP-3比值亦明显增高,差异均有显著性(P<0.01)。③肝癌组与肝硬化患者代偿期组比较血浆u-PA、u-PAR、MMP-3、TIMP-1水平和TIMP-1/MMP-3比值均明显增高,差异均有显著性(P<0.01);肝癌组与肝硬化失代偿期组比较血浆u-PA、u-PAR和MMP-3水平均无显著性差异(P>0.05),而血浆TIMP-1水平和TIMP-1/MMP-3比值明显增高,差异有显著性(P<0.01)。结论:乙型肝炎后肝硬化和肝癌患者血浆MMP-3、TIMP-1、u-PA和u-PAR水平变化与疾病的病理进程有密切相关。
Objective: To investigate the relationship between plasma matrix metalloproteinase 3 (MMP-3), matrix metalloproteinase inhibitor-1 (TIMP-1) and urokinase-type plasminogen activator (u-PA) in patients with posthepatitic cirrhosis and hepatocellular carcinoma And its receptor (u-PAR) levels and its clinical significance. Methods: The levels of MMP-3, TIMP-1, uPA and u-PAR in plasma were determined by enzyme linked immunosorbent assay (ELISA). Results: ① Compared with the normal control group, the levels of plasma MMP-3 and u-PAR in decompensated cirrhosis patients were significantly increased (P <0.01); in patients with cirrhosis, the levels of plasma u-PA , The levels of u-PAR, TIMP-1 and TIMP-1 / MMP-3 were significantly increased, the difference was significant (P <0.01 and P <0.05); the levels of u-PA and u- (P <0.01), which was about twice as high as the control group. The ratios of TIMP-1 and TIMP-1 / MMP-3 also increased significantly (P <0.01). ② The levels of u-PA, u-PAR and MMP-3 in patients with decompensated liver cirrhosis were significantly higher than those in decompensated patients, the ratio of TIMP-1 / MMP-3 was also significantly increased, the difference was significant P <0.01). ③The levels of u-PA, u-PAR, MMP-3, TIMP-1 and TIMP-1 / MMP-3 in liver cancer group and cirrhosis group were significantly higher than those in decompensated liver cirrhosis group (P < 0.01). There were no significant differences in the levels of u-PA, u-PAR and MMP-3 between the hepatocellular carcinoma group and the decompensated liver cirrhosis group (P> 0.05), while the levels of plasma TIMP-1 and TIMP- 1 / MMP -3 ratio was significantly higher, the difference was significant (P <0.01). Conclusion: The changes of plasma MMP-3, TIMP-1, u-PA and u-PAR levels in patients with posthepatitic cirrhosis and liver cancer are closely related to the pathological process of the disease.