非酒精性脂肪性肝病儿童血清TIMP-1和TIMP-2检测及临床意义

Determination and clinical significance of tissue inhibitors of metalloproteinase-1 and -2 in serum of children with nonalcoholic fatty liver disease

摘要:

目的：了解非酒精性脂肪性肝病患儿基质金属蛋白酶组织抑制物（TIMP）-1和TIMP-2的水平及价值。方法根据诊断标准将105例肥胖儿童分为单纯性肥胖（n=44）、单纯性非酒精性脂肪肝（SNAFL，n=25）和非酒精性脂肪肝炎（NASH，n=36）3组，采用酶联免疫吸附方法(ELISA)测定血清TIMP-1、TIMP-2，全自动酶法测定丙氨酸氨基转移酶(ALT)和γ-谷氨酸转肽酶(γ-GT)。结果随着单纯性肥胖向SNAFL和NASH发展，TIMP-1和γ-GT水平逐步升高，差异有统计学意义(P<0.05)；TIMP-1、TIMP-2两者均与γ-GT水平呈显著正相关(r=0.534,P<0.01；r=0.351,P<0.05)。NASH组TIMP-1阳性率明显高于SNAFL组(P﹤0.05)，而TIMP-2阳性率两组之间差异无统计学意义 (P>0.05)。结论 血清TIMP-1和TIMP-2指标均可不同程度地反映肝脏的纤维化程度，其中以TIMP-1更为可靠、有效。［中国当代儿科杂志，2010，12（6）：455-458］

Abstract:

OBJECTIVE: To examine serum tissue inhibitors of metalloproteinases (TIMP) -1 and -2 levels in children with nonalcoholic fatty liver disease and to investigate possible roles of the two markers. METHODS: One hundred and five obese children were classified into 4 groups: simple obesity (n=44), simple nonalcoholic fatty liver (SNAFL, n=25), and nonalcoholic steatohepatitis (NASH, n=36). Serum TIMP-1 and -2 levels were measured using ELISA. Serum ALT and γ-GT levels were measured with totally automatic enzymatic method. RESULTS: Serum levels of TIMP-1 and γ-GT increased with the disease development from simple obesity to SNAFL and NASH (P<0.05). Both serum TIMP-1 and -2 levels were positively correlated with γ-GT levels (r=0.534，P<0.01; r=0.351, P<0.05, respectively). Ninety-seven percent of children in the NASH group had serum TIMP-1 levels over 2 standard deviations of healthy controls (83.35 μg/ L) compared with 76% in the SNAFL group (P﹤0.05). There were no significant differences in the case proportion with TIMP-2 levels over 2 standard deviations of healthy controls between the NASH and the SNAFL groups. CONCLUSIONS: Both TIMP-1 and -2 may reflect the state of liver fibrosis in children with nonalcoholic fatty liver disease, and serum TIMP-1 appears to be more reliable.［Chin J Contemp Pediatr, 2010, 12 (6):455-458］