目的 探讨血清组织型金属蛋白酶抑制剂4(TIMP-4)水平对老年慢性心力衰竭(CHF)早期诊断及预后评估的价值.方法 选择老年CHF患者160例(CHF组),其中轻度68例、重度92例,另选体检健康的老年志愿者40例(对照组).采用彩色多普勒超声诊断仪检测两组左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF).采集肘静脉血,采用双抗体夹心ELISA法检测血清TIMP4.采用受试者工作特征(ROC)曲线分析血清TIMP-4对老年CHF的早期诊断价值.老年CHF患者出院3、6、9个月复查心脏彩超,统计心脏事件的发生情况.结果 CHF组LVEDD明显高于对照组,LVEF、TIMP4明显低于对照组,以重度CHF患者上述指标变化更明显(P均<0.05);相关分析显示,老年CHF患者血清TIMP4水平与LVEF呈正相关关系(r=0.816,P<0.05),与LVEDD呈负相关关系(r=-0.266,P<0.05).ROC曲线分析显示,血清TIMP-4诊断老年CHF的曲线下面积为0.916(95% CI:0.869～0.951),其cut off值为1.41 ng/mL,此时血清TIMP4诊断老年CHF的敏感性为77.0%、特异性为92.0%.以血清TIMP4水平的cut off值为截断值,将老年CHF患者分为TIMP-4高水平者(TIMP-4> 1.41ng/mL)46例和TIMP-4低水平者(TIMP-4≤1.41 ng/mL) 114例;TIMP4高水平者和TIMP4低水平者出院3个月无心脏事件生存率比较P>0.05,而TIMP-4高水平者出院6、9个月无心脏事件生存率明显高于TIMP4低水平者(P均<0.05).结论 血清TIMP-4可作为老年CHF患者早期诊断和预后判断的预测指标之一.%To explore the value of tissue inhibitor of metalloproteinase-4 (TIMP-4) in the early diagnosis and prognosis of elderly patients with chronic heart failure (CHF).Methods A total of 160 cases of elderly CHF patients (CHF group) including 68 cases of mild heart failure and 92 cases of severe heart failure were selected,meanwhile,another 40 health elderly people were selected as the control group.The left ventrieular end diastolic dimension (LVEDD) and left ventricular ejection fraction (LVEF) in the two groups were detected,the venous blood was extracted to determine the serum levels of TIMP-4 by double antibody sandwich enzyme-linked immunosorbent assay (ELISA).The early diagnosis value of serum TIMP-4 for CHF were analyzed by ROC curve.At 3,6,and 9 months after discharge,we reviewed the heart color Doppler ultrasound of elderly CHF patients and did the statistics of their heart events.Results The LVEDD in the CHF group was significantly higher than that of the control group,whereas LVEF and TIMP-4 were significantly lower than those of the control group,especially in the severe heart failure patients (all P < 0.05);correlation analysis showed that the serum TIMP-4 level was positively correlated with LVEF (r =0.816,P < 0.05),and was negatively correlated with LVEDD (r =-0.266,P < 0.05).ROC curve analysis showed that the area under the curve (AUC) of serum TIMP-4 in diagnosis of elderly CHF patients was 0.916 (95% CI:0.869-0.951) with the sensitivity of 77.0% and the specificity of 92.0%.The cut-off value was 1.41 ng/mL.According to the cut-off value,we divided the elderly CHF patients in the high level TIMP-4 group (TIMP-4 > 1.41 ng/mL,n =46) and low level TIMP-4 group (TIMP-4≤1.41 ng/mL,n =114).The 3-month cardiac event-free survival between the high level TIMP-4 group and low level TIMP-4 group was not significant different (P > 0.05).The 6-month and 9-month cardiac event-free survival in the high level TIMP-4 group was significantly higher than that in the low level TIMP-4 group,and the difference between the two groups was statistically significant (P < 0.05).Conclusion Serum TIMP-4 can be used as a predictor for the early diagnosis and prognosis of elderly patients with CHF.
wenku.so.comtimp估目标:TIMP估目的概和应用引:TIMP估目是对特定人群的一估工具,旨在估个体在动力、日常生活技和社交交往力等方的发展情况。目可广
www.so.comContentsPage目录页奈普生药理作用概述奈普生临床疗效评估奈普生药理作用概述非甾体抗炎药(NSAIDs)作用机制1非甾体抗炎药通过抑制环氧合酶(COX)酶活性,减少前列腺素的合成,从而达
www.so.com目的:分析胃癌患者癌组织中基质金属蛋白酶9(MMP-9)和组织金属蛋白酶抑制剂1(TIMP-1)的表达,探讨其在胃癌根治术后患者预后评估中的价值。方法:选取270例行胃癌根治术的胃癌患者,采用免疫组织化学染色法检测胃癌组织中MMP-9和TIMP-1蛋白阳性表达率。采用χ2检验或Fisher精确概率法分析MMP-9和TIMP-1阳性表达在不同临床病理特征胃癌患者中的分布情况。采用Kaplan-Meier法绘制生存曲线,Log-rank检验比较生存曲线的差异。采用多因素Cox回归模型分析MMP-9和TIMP-1表达与胃癌患者预后的关系。结果:270例胃癌患者中,MMP-9和TIMP-1蛋白的表达部位为肿瘤细胞膜或细胞浆,MMP-9和TIMP-1蛋白阳性表达率分别为30.4%和26.3%。MMP-9和TIMP-1联合表达在不同年龄、性别、肿瘤大小、肿瘤类型、组织学分级、术后化疗和TNM分期胃癌患者中的分布比较差异无统计学意义(P>0.05)。Cox回归模型评估,MMP-9和TIMP-1联合表达、TNM分期和术后化疗是影响胃癌患者预后的独立因素,其中MMP-9^(+)与胃癌患者的良好预后相关,MMP-9-/TIMP-1^(+)胃癌患者的死亡风险提高,预后更差(MMP-9+/TIMP-1^(+)/-vs MMP-9-/TIMP-1^(+):HR=0.537,95%CI:0.338~0.851,P=0.008)。TNM分期为Ⅲ期、未接受术后化疗的胃癌患者较TNM分期为Ⅰ/Ⅱ期、接受化疗的胃癌患者死亡风险更高,预后更差(HR=1.873,95%CI:1.334~2.631,P<0.001;HR=2.301,95%CI:1.656~3.197,P<0.001)。分层分析,在TNM分期为Ⅰ/Ⅱ期、接受术后化疗和非印戒细胞型的胃癌患者中,MMP-9^(+)胃癌患者的死亡风险较MMP-9-/TIMP-1^(+)患者明显降低,预后更好(P<0.05)。结论:MMP-9/TIMP-1联合表达可作为胃癌根治术后患者预后评估的独立预测因子;术后未化疗和TNM分期为Ⅲ期是胃癌根治术后患者预后的独立危险因素。
www.so.com2024年12月4日 - 通过TIMP评估,可以对婴儿早期的姿势和运动能力进行全面、科学的评价,从而及时筛查出异常婴儿,为早期干预提供有力依据。.1、TIMP评估有助于早期发现运...
www.so.com2025年4月16日 - TIMP评估是针对新生儿运动发育的标准化量表,通过大动作、精细动作、适应能力、语言及社会行为五个维度的综合评分反映脑发育状况.1. 定期监测婴儿运动...
www.so.com2023年4月23日 - 你好,新生儿TIMP主要是评估婴儿的运动发育是否落后,总分142,一般80分以上算合格.TIMP分数的测评结果,与婴儿当时的精神状态,测试环境及测试者对评估表...
www.so.com2025年1月27日 - 研究表明,对有高危因素的早产儿进行早期评估和干预,可以明显改善他们的预后.这个量表主要是针对有高危因素的早产儿和脑损伤高危婴儿,通过评估婴儿早期...
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