血清TIMP-1、M-CSF联合检测对老年病人乙型肝炎后肝硬化早期诊断的价值

doi:10.3969/j.issn.1003-9198.2024.06.015

摘要/Abstract

摘要： 目的探讨血清基质金属蛋白酶抑制因子-1(TIMP-1)、巨噬细胞集落刺激因子(M-CSF)水平对老年病人乙型肝炎后肝硬化早期诊断的价值。方法回顾性纳入2020年3月至2022年5月医院收治的97例老年乙型肝炎后肝硬化病人为研究组,另回顾性纳入医院同时间段收治的125例老年乙型肝炎病人为对照组。根据病人肝硬化程度将研究组分为肝硬化A级39例、肝硬化B级33例、肝硬化C级25例。比较各组间血清TIMP-1、M-CSF水平的差异,分析血清TIMP-1水平与血清M-CSF水平的相关性,分析老年乙型肝炎病人发生肝硬化的影响因素,分析血清TIMP-1、M-CSF联合检测对老年乙型肝炎病人发生肝硬化的诊断价值。结果研究组总胆红素(TBIL)、甲胎蛋白(AFP)水平高于对照组,凝血酶原时间(PT)长于对照组(P＜0.01),白蛋白(ALB)水平低于对照组(P＜0.01);研究组血清TIMP-1、M-CSF水平高于对照组(P＜0.01);血清TIMP-1、M-CSF水平随着肝硬化程度加重而逐渐升高(P＜0.05); 血清TIMP-1水平与血清M-CSF水平呈正相关(P＜0.05)。血清TBIL、TIMP-1、M-CSF、ALB及 PT为老年乙型肝炎病人发生肝硬化的影响因素(P＜0.05)。血清TIMP-1、M-CSF水平及二者联合诊断老年乙型肝炎病人发生肝硬化的AUC分别为0.821、0.813、0.896(P＜0.05),且二者联合诊断价值更高(P＜0.05)。结论血清TIMP-1、M-CSF水平在早期诊断老年病人乙型肝炎后肝硬化中具有重要价值,且二者联合具有更高的诊断价值。

关键词: 基质金属蛋白酶抑制因子-1, 巨噬细胞集落刺激因子, 老年人, 乙型肝炎, 肝硬化, 诊断价值

Abstract: Objective To investigate the value of serum tissue inhibitors of metalloproteinase-1 (TIMP-1) and macrophage colony-stimulating factor (M-CSF) levels in the early diagnosis of post-hepatitis B cirrhosis in the elderly patients. Methods A total of 97 elderly patients with post-hepatitis B cirrhosis admitted to our hospital from March 2020 to May 2022 were enrolled as the study group, and 125 elderly patients with hepatitis B during the same period were enrolled as the control group. According to the degree of cirrhosis, the study group was divided into 39 patients with grade A cirrhosis, 33 patients with grade B cirrhosis and 25 patients with grade C cirrhosis. The serum TIMP-1 and M-CSF levels were compared between the two groups and the patients with different grades of cirrhosis, and the correlation between serum TIMP-1 level and serum M-CSF level was analyzed. The influencing factors of cirrhosis in the elderly patients with hepatitis B were analyzed, and the diagnostic value of serum TIMP-1 and M-CSF levels for post-hepatitis B cirrhosis in the elderly patients was analyzed. Results The levels of total bilirubin (TBIL), alpha-fetoprotein (AFP) and prothrombin time (PT) in the study group were higher than those in the control group (P<0.01), and the level of albumin (ALB) was lower than that in the control group (P<0.01). The levels of TIMP-1 and M-CSF in the study group were higher than those in the control group (P<0.01). The serum levels of TIMP-1 and M-CSF in the patients with grade C cirrhosis were highest, followed by grade B and grade A (P<0.05). Serum TIMP-1 level was positively correlated with serum M-CSF level (P< 0.05). Logistic regression analysis showed that TBIL, PT, TIMP-1, M-CSF and ALB were the influencing factors for cirrhosis in the elderly patients with hepatitis B (P<0.05). The area under the curve (AUC) of serum TIMP-1, M-CSF and combination in diagnosing liver cirrhosis in the elderly patients with hepatitis B was 0.821, 0.813 and 0.896, respectively (P<0.05), and the AUC of combination of TIMP-1 and M-CSF was higher (P<0.05). Conclusions Serum TIMP-1 and M-CSF levels have important value in early diagnosis of post-hepatitis B cirrhosis in the elderly patients, and their combination has higher diagnostic value.

Key words: tissue inhibitors of metalloproteinase-1, macrophage colony stimulating factor, aged, hepatitis B, liver cirrhosis, diagnostic value

中图分类号:

R512.62

史华, 何志威, 甘轲. 血清TIMP-1、M-CSF联合检测对老年病人乙型肝炎后肝硬化早期诊断的价值[J]. 实用老年医学, 2024, 38(6): 607-611.

SHI Hua, HE Zhiwei, GAN Ke. Value of serum TIMP-1 and M-CSF levels in early diagnosis of post-hepatitis B cirrhosis in elderly patients[J]. Practical Geriatrics, 2024, 38(6): 607-611.

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