摘要
目的:观察妊娠期肝内胆汁淤积症(ICP)产妇血清基质金属蛋白酶-9(MMP-9)、磷脂转运蛋白(PLTP)、白细胞介素-18(IL-18)水平变化,探讨其在ICP发病中的作用。方法:将ICP孕妇80例设为ICP组,并按指南将ICP患者分为轻度组(n=48)及重度组(n=32),将同期40名正常孕妇设为对照组,均行血清MMP-9、PLTP、IL-18及肝功能指标检测,并将其进行相关性分析;采用ROC曲线评价血清MMP-9、PLTP、IL-18水平诊断ICP及重度ICP的临床价值。结果:ICP组血清MMP-9、PLTP、IL-18水平均明显高于对照组(P<0.05),且重度组明显高于轻度组(P<0.05)。Spearman相关分析显示ICP组血清MMP-9、PLTP、IL-18水平与总胆红素、谷丙转氨酶、谷草转氨酶水平均呈正相关(P<0.05)。ROC曲线分析显示血清MMP-9、PLTP、IL-18水平诊断ICP的曲线下面积分别为0.710(95%CI:0.597~0.823)、0.979(95%CI:0.951~1.000)和0.953(95%CI:0.910~0.997),诊断重度ICP的曲线下面积分别为0.658(95%CI:0.539~0.777)、0.963(95%CI:0.921~1.000)和0.911(95%CI:0.838~0.984)。结论:MMP-9、PLTP和IL-18可作为ICP诊断的指标之一。
Objective:To observe the changes in levels of serum matrix metalloproteinase-9(MMP-9),phospholipid transfer protein(PLTP)and interleukin-18(IL-18)in puerperae with intrahepatic cholestasis of pregnancy(ICP),and to investigate their roles in pathogenesis of ICP.Methods:According to the guideline,80 pregnant women with ICP were divided into mild group(n=48)and severe group(n=32),and 40 normal pregnant women in the same period were selected as the control group.All of them were tested for serum MMP-9,PLTP and IL-18 and liver function,and correlation analysis was performed.The clinical value of serum MMP-9,PLTP and IL-18 levels in diagnosis of ICP and severe ICP was evaluated by ROC curve.Results:The levels of serum MMP-9,PLTP and IL-18 in ICP group were significantly higher than those in the control group(P<0.05),the levels in severe group were significantly higher than those in the mild group(P<0.05).Spearman correlation analysis showed that levels of serum MMP-9,PLTP and IL-18 were positively correlated with levels of total bilirubin,alanine aminotransferase and aspartate aminotransferase levels in ICP group(P<0.05).ROC curve analysis showed that the areas under the curves of serum MMP-9,PLTP and IL-18 levels for diagnosis of ICP were 0.710(95%CI:0.597~0.823),0.979(95%CI:0.951~1.000)and 0.953(95%CI:0.910~0.997),respectively.The areas under the curves for diagnosis of severe ICP were 0.658(95%CI:0.539~0.777),0.963(95%CI:0.921~1.000)and 0.911(95%CI:0.838~0.984),respectively.Conclusion:MMP-9,PLTP and IL-18 can be used as a indicator for diagnosis of ICP.
作者
池晶晶
CHI Jing-jing(Beijing Shijitan Hospital Affiliated to Capital Medical University,Beijing 100038,China)
出处
《川北医学院学报》
CAS
2021年第1期99-102,共4页
Journal of North Sichuan Medical College
