首页 | 官方网站   微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 62 毫秒
1.
目的:评估血清基质金属蛋白酶抑制剂-1(TIMP-1)在肝纤维化诊断中的临床价值。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(S0~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、CⅣ、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±29.2)、(161.2±43.2)、(221.6±93.8)μg/L,对照组和S2~S4组及S0~S1组和S2~S4组间比较差异均有统计学意义(t分别为5.32、4.98,P0.01)。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0.801(95%CI:0.762~0.940),TIMP-1在临界值为170.3μg/L时,其敏感度、特异度分别为88.5%、80.4%,高于HA(79.6%、72.5%),PCⅢ(72.5%、78.5%),CⅣ(63.6%、78.4%)和LN(78.5%、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。  相似文献   

2.
目的观察慢性乙型肝炎患者血清基质金属蛋白酶-1(MMP-1)及基质金属蛋白酶组织抑制因子-1(TIMP-1)水平与肝脏炎症活动度及纤维化程度的相关性,寻找新的判断肝纤维化程度的血清学指标。方法慢性乙肝患者64例,均行肝穿刺活检,病理组织进行炎症活动度分级(G)及纤维化程度分期(S),用双抗体夹芯酶联免疫吸附方法检测血清MMP-1及TIMP-1水平,用放射免疫法检测血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原N端肽(PⅢNP)、Ⅳ型胶原(C-Ⅳ)的水平。结果随着肝脏炎症活动度及纤维化程度加重,血清MMP-1水平逐渐降低,而TIMP-1水平逐渐升高,除G1与G2、S1与S2比较差异无统计学意义外,其余各组之间两两比较均有统计学意义(P<0.05或P<0.01);血清TIMP-1与纤维化分期呈正相关(r=0.496,P=0.003),与炎症活动度分级呈正相关(r=0.460,P=0.005);血清MMP-1与纤维化分期呈负相关(r=-0.443,P=0.004),与炎症活动度分级呈负相关(r=-0.419,P=0.007),且血清MMP-1及TIMP-1与HA、PⅢNP具有良好相关性。结论血清TIMP-1和MMP-1水平可作为评估肝纤维化发展或减轻的指标。  相似文献   

3.
目的探讨国产化学发光(CL)试剂检测血清肝纤维化标志物透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原氨基端肽(PⅢNP)、Ⅳ型胶原(CⅣ)对肝纤维化的诊断价值。方法采用CL法检测123例有病理诊断的慢性肝炎患者(病例组)及30例健康体检者(对照组)的血清HA、LN、PⅢNP、CⅣ,病例组按纤维化程度分为S0~S4期,评价4项指标对肝纤维化的诊断价值。结果病例组HA、LN、CⅣ明显高于对照组[(4.47±0.86)vs.(2.02±0.23),P=0.000;(4.15±0.81)vs.(3.57±0.67),P=0.002;(3.49±0.89)vs.(2.15±0.81),P=0.000]。4项指标均呈现对照组S0,S1S2,S2S3,S4期HA与CⅣ下降、LN与PⅢNP升高。不同肝纤维化分期的患者中4项指标组间差异均有统计学意义(P0.01),4项指标的S0与S1期比较,差异无统计学意义(P0.05),而S0与S2期、S1与S2期比较,差异均有统计学意义(P0.05)。LN、PⅢNP、CⅣ3项指标与肝纤维化程度有正相关性(P均0.01)。诊断肝纤维化的受试者工作特征曲线(ROC曲线)下面积(AUC)依次为CⅣ(0.790)HA(0.775)LN(0.725)PⅢNP(0.644)。HA、HA+LN+CⅣ3项联合、4项联合对肝纤维化诊断的敏感性及准确率较高;综合诊断效能CⅣLNPⅢNP;单项及联合检测的阳性似然比为1~3。结论 4项指标对肝纤维化诊断均有一定价值,但对早期肝纤维化诊断的意义有限,当纤维化程度为S2期时,其意义最明显。随着肝纤维化程度加重,HA与CⅣ反呈下降趋势,可能与细胞外基质的分解降低有关。多指标联合适合在排除肝纤维化时应用;所有单项及联合检测对诊断肝纤维化的阳性似然比均较低,说明其诊断价值有限,不能替代肝组织活检。  相似文献   

4.
《北京医学》2012,34(3)
目的 探讨国产化学发光(CL)试剂检测血清肝纤维化标志物透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原氨基端肽(PⅢNP)、Ⅳ型胶原(CⅣ)对肝纤维化的诊断价值.方法 采用CL法检测123例有病理诊断的慢性肝炎患者(病例组)及30例健康体检者(对照组)的血清HA、LN、PⅢNP、CⅣ,病例组按纤维化程度分为S0~S4期,评价4项指标对肝纤维化的诊断价值.结果 病例组HA、LN、CⅣ明显高于对照组[(4.47±0.86) vs.(2.02±0.23),P=0.000; (4.15±0.81) vs.(3.57±0.67),P=0.002; (3.49±0.89) vs.(2.15±0.81),P=0.000].4项指标均呈现对照组<S0,S1<S2,S2>S3,S4期HA与CⅣ下降、LN与PⅢNP升高.不同肝纤维化分期的患者中4项指标组间差异均有统计学意义(P<0.01),4项指标的S0与S1期比较,差异无统计学意义(P>0.05),而S0与S2期、S1与S2期比较,差异均有统计学意义(P<0.05).LN、PⅢNP、CⅣ3项指标与肝纤维化程度有正相关性(P均<0.01).诊断肝纤维化的受试者工作特征曲线(ROC曲线)下面积(AUC)依次为CⅣ(0.790)>HA (0.775)>LN (0.725)>PⅢNP (0.644).HA 、HA+LN+CⅣ3项联合、4项联合对肝纤维化诊断的敏感性及准确率较高;综合诊断效能CⅣ>LN>PⅢNP;单项及联合检测的阳性似然比为1~3.结论 4项指标对肝纤维化诊断均有一定价值,但对早期肝纤维化诊断的意义有限,当纤维化程度为S2期时,其意义最明显.随着肝纤维化程度加重,HA与CⅣ反呈下降趋势,可能与细胞外基质的分解降低有关.多指标联合适合在排除肝纤维化时应用;所有单项及联合检测对诊断肝纤维化的阳性似然比均较低,说明其诊断价值有限,不能替代肝组织活检.  相似文献   

5.
目的 观察慢性乙型肝炎患者血小板源生长因子(PDGF)水平的变化,分析其与患者病情程度及肝纤维化血清学指标透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原氨基端肽(PⅢNP)、Ⅳ型胶原(Ⅳ.C)水平的关系.方法 采用ELISA、RIA分别检测40例正常人、40例慢性乙型肝炎 (轻度17例、中度12例和重度11例) 患者的血清PDGF、HA、LN、PⅢNP、Ⅳ.C水平.结果慢性肝炎患者各组PDGF及所测血清学指标明显高于正常组(P<0.05),PDGF水平按病情严重程度依次升高,各组之间均存在显著性差异(P<0.05),并与所测肝纤维化血清学指标的水平正相关,相关系数(r)分别为0.799、0.353、0.785、0.758,P值均<0.05.结论 PDGF随肝功能损害加重而升高,且PDGF水平升高与血清肝纤维化指标水平升高呈正相关,提示PDGF可促进慢性肝病患者肝纤维化的发展.  相似文献   

6.
目的探讨乙型肝炎患者血清转化生长因子β1(TGF-β1)水平与肝纤维化的关系,评价其对判断肝纤维化及诊断肝硬化的价值.方法用酶免疫法测定 123例各临床型乙型肝炎患者血清TGF-β1水平,同时用ELA及RIA法检测血清透明质酸(HA )、粘层蛋白(LN)、Ⅳ型胶原(Ⅳ- C)、Ⅲ型前胶原肽(PⅢP)水平.其中30例慢性肝炎患者同时行肝组织穿刺活检.比较各组肝炎之间血清TGF-β1水平的差异,分析其与HA 、LN、Ⅳ- C、 PⅢP四项肝纤维化指标及肝组织病理纤维化程度分期和炎症活动分级的相关性.结果乙型肝炎患者血清TGF-β1水平均明显高于正常对照者(P<0.05),并随着肝纤维化程度加重而逐渐增高;血清TGF-β1水平与四项肝纤维化指标呈正相关关系.肝组织炎症活动时,血清TGF-β1水平明显升高(P<0.05),但在各级之间无明显差异,两者间无相关性;而血清TGF-β1水平与肝组织纤维化呈正相关(r=0.612,P<0.05).在肝纤维化程度S0-1与S2-3之间血清TGF-β1水平比较无显著性差异;进入肝硬化后血清TGF -β1升至较高水平,明显高于非肝硬化者(P<0.05).结论血清TGF-β1水平与乙型肝炎患者肝纤维化的发展程度有关系,且不受肝组织炎症程度影响.可作为一种肝纤维化诊断的辅助手段之一,与血清HA、LN、Ⅳ-C、PⅢP四项肝纤维化指标联合检测,可进一步提高肝纤维化血清学诊断的准确性;但不能替代肝穿病理组织检查.  相似文献   

7.
乙肝患者血清学标志物与肝纤维化的关系   总被引:4,自引:0,他引:4  
郑利平  潘爱萍 《广东医学》2008,29(7):1143-1145
目的评价血清纤维化指标透明质酸(HA)、Ⅲ型前胶原肽(PⅢP)、Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)、纤维连接蛋白(FN)、基质金属蛋白酶(MMP-2)及其抑制物(TIMP-1)对肝纤维化诊断的价值。方法采用放射免疫法检测80例肝病患者肝纤维化血清学标志物水平,并与患者的肝组织病理学检查作对比。结果肝纤维化血清指标HA,PⅢP,CⅣ,LN,MMP-2,TIMP-1,大部分指标纤维化各期及炎症各级的值比正常人显著升高(P<0.05或0.01);仅FN指标,肝纤维化患者显著降低(P<0.05或0.01)。血清HA,PⅢP,CⅣ,LN,MMP-2,TIMP-1与肝纤维分期显著正相关(P<0.05或0.01);与炎症分级呈正相关(P<0.05或0.01)。仅FN与肝脏病理分期、分级呈负相关(P<0.05)。结论血清纤维化指标与肝纤维化分期分级存在显著相关性,具有重要临床意义。  相似文献   

8.
血清肝纤维化指标与肝纤维化的关系   总被引:7,自引:0,他引:7  
目的 :探讨慢性肝病患者血清Ⅲ型前胶原 (PCⅢ )、Ⅳ型胶原 (CⅣ )、透明质酸 (HA)及层粘蛋白 (LN)水平与肝纤维化的关系及其诊断肝纤维化的意义。方法 :采用放射免疫法检测 118例慢性肝病患者血清PCⅢ、CⅣ、HA及LN水平 ,其中 86例患者行肝活检并与肝组织病理学分期进行比较 ,分析上述血清学指标与肝纤维化的关系。结果 :上述四项血清学指标随病情进展而逐渐升高 ,与肝纤维化的程度相一致 (P <0 .0 5 )。结论 :血清PCⅢ、CⅣ、HA及LN水平与肝纤维化程度相关 ,可作为反映肝纤维化程度的指标。  相似文献   

9.
目的 探讨肝纤维化指标、基质金属蛋白酶抑制因子-1(TIMP-1)在慢性乙型肝炎纤维化中的诊断效能及与肝硬化的关联性.方法 选取2017年2月至2019年6月广东省农垦中心医院收治的慢性乙型肝炎纤维化患者119例设为研究组、同期体检健康者119例设为对照组.入院后抽取两组受检者空腹外周静脉血,经酶促化学发光免疫分析法测定肝纤维化指标[血清Ⅳ型胶原(CⅣ)、Ⅲ型前胶原氨基端肽(PⅢP)、层粘连蛋白(LN)、透明质酸(HA)]水平,酶联免疫吸附法(ELISA)测定血清TIMP-1水平.统计两组及不同肝硬化程度(代偿期、失代偿期)患者血清肝纤维化指标、TIMP-1水平,并分析血清肝纤维化指标、TIMP-1诊断效能及其与肝硬化间的关系.结果 研究组血清CⅣ、PⅢP、LN、HA、TIMP-1水平高于对照组(P<0.05);失代偿期肝硬化患者血清CⅣ、PⅢP、LN、HA、TIMP-1水平高于代偿期肝硬化患者(P<0.05);经Pearson相关性分析可知,血清CⅣ(r=0.793)、PⅢP(r=0.783)、LN(r=0.765)、HA(r=0.812)、TIMP-1(r=0.803)水平与肝硬化程度间存在正相关关系(P<0.05);血清肝纤维化指标联合TIMP-1诊断肝硬化灵敏度97.48%、准确度96.22%,高于肝纤维化指标(87.39%、92.44%)、TIMP-1(83.19%、89.50%)单独诊断(P<0.05);联合诊断特异度(94.96%)与肝纤维化指标(97.48%)、TIMP-1(95.80%)单独诊断比较,差异无统计学意义(P>0.05).结论 肝纤维化指标、T I MP-1在慢性乙型肝炎纤维化患者中呈异常高表达状态,联合检测可显著提高诊断灵敏度、准确度,不影响诊断特异度,且与肝硬化呈正相关.  相似文献   

10.
[摘要] 目的 评价血清纤维化指标透明质酸(HA)、Ⅲ型前胶原肽( PⅢP)、Ⅳ型胶原 ( CⅣ)、层粘连蛋白(LN)、纤维连接蛋白(FN)、基质金属蛋白酶(MMP-2) 及其抑制物(TIMP-1)对肝纤维化诊断的价值。方法 采用放射免疫法检测80例肝病患者肝纤维化血清学标志物水平,并与患者的肝组织病理学检查作对比。结果 肝纤维化血清指标HA、PⅢP、CⅣ、LN、MMP-2、TIMP-1,大部分指标纤维化各期及炎症各级的值比正常人显著升高(P<0.05或0.01);仅FN指标,肝纤维化患者显著降低(P<0.05或0.01)。血清HA、PⅢP、CⅣ、LN、MMP-2、TIMP-1与肝纤维分期显著正相关(P<0.05或0.01);与炎症分级显著正相关(P <0.05或0.01)。仅FN与肝脏病理分期、分级显著负相关(P<0.05)。结论 血清纤维化指标与肝纤维化分期分级存在显著相关性,具有重要临床意义。  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
Shock wave lithotripsy (SWL) is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it's difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.  相似文献   

14.
Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.  相似文献   

15.
INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5  相似文献   

16.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

17.
People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.  相似文献   

18.
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…  相似文献   

19.
Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and > 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.  相似文献   

20.
Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司    京ICP备09084417号-23

京公网安备 11010802026262号