摘要
目的评估血清基质金属蛋白酶抑制剂-1（TIMP-1）在在肝纤维化诊断中的I临床价值。方法285例慢性乙型肝炎（CHB）患者，根据肝穿刺病理诊断结果分为无明显纤维化组（SO—S1）和明显纤维化组（S2-S4）。将病理诊断结果作为金标准，使用ROC曲线评估TIMP-1诊断肝纤维化的敏感度、特异性和符合率，并和肝纤维化标记物HA、PCIII、C1V、LN比较其诊断性能。结果对照组、S0-S1组、S2-S4组TIMP-1血清浓度分别为146．6士29．2、161．2士43．2、221．6土93．8μg／L，对照组和S2-S4组及S0-S1组和S2-S4组间差异有统计学意义（t分别为5．32、4．98，P均小于0．01）。TIMP-1区分慢性乙肝明显纤维化和轻度纤维化的ROC曲线下面积（AUC）为0．841（95％CI：0．762～0．920），TIMP-1在临界值为170．3μg／L时，其敏感度、特异度分别为71．5％、82．4%，高于HA（75．6％、72．5％）、PCIII（70．5％、76．5％）、CIV（63．6％、78．4％）、LN（79．5％、64．7％）。结论血清TIMP-1诊断肝纤维化有较高的敏感度和特异性，血清TIMP-1可能是预测肝纤维化分期一个较好的指标。
Objective To evaluate the clinical value of TIMP^I in diagnosis of liver fibrosis. Methods Patients with CHB were divided into mild liver fibrosis group（ S0-S1,175 ） and significant liver fibrosis group（S2-S4,110 ）, accord- ing to pathological diagnosis. The diagnostic capacity of CTGF was assessed by comparing the area under receiver operating characteristic（AUC） with a panel of fibrosis markers. Results Serum level of TIMP-1 in control group, S0-S1 ,$2-$4 was 146.6±29.2,161.2±43.2,221.6±93.8 μg/L,respectively. The level of TIMP-1 in S2-S4 group was significantly higher than that of S0-S1 group （t= 5.32, P〈0. 01） and that of control group（t= 4. 98, P〈0.01 ）. The area ROC of TIMP-1 was 0.841（95% confidence interval, 0. 762 -0. 920） in distinguishing mild fibrosis from significant fibrosis, which was highest among five markers. When cutoff value of TIMP-1 was 10.3 μg/L, the sensi- tivity and specification was 70.5%,82.4% which were higher than that of HA（75.6%,72.5%）,PCIII （70. 5%, 76.5 % ） ,CIV （63.6%, 78. 4% ）, LN （79.5%, 64.7% ）, APRI （ 86.3%, 66.1% ） for assessing liver fibrosis. Conclusions Serum TIMP-1 has higher sensitivity, specificity in assessment of liver fibrosis, which may be a valuable marker for assessing liver fibrosis.
出处
《中国误诊学杂志》
CAS
2012年第15期3817-3819,共3页
Chinese Journal of Misdiagnostics
