Abstract

67 middle-aged (48 ± 1 years) patients with diffuse liver disease of various origins have been examined. It has been established that an increase in the degree of fibrosis is associated with an increase in the resonance intensity of glucose-6-phosphates, adenosine monophosphate (AMP), inosine monophosphate (IMP), pyrophosphates, and 2,3-bisphosphoglyceric acid (BPG) and a decrease in the resonances of inorganic phosphates and phosphocreatine, γ-, α-, and β-AMP, uridine triphosphate (UTP), Hb- and Mg-adenosine triphosphate (ATP), and β- and α- adenosine diphosphate (ADP). The predictive value of a positive result of ³¹P NMR spectroscopy of erythrocytes for liver fibrosis is 92.3% (the sensitivity is 85.71% and the specificity is 80%). In the IR spectra of the blood serum of patients with severe fibrosis, in contrast to the cases of moderate fibrosis, the resonance intensity is higher at 1280 and 3190 cm^‒1 and significantly lower at 776, 818, 889, 966, 1399, 1450, 1570, and 1635 cm^‒1, which indicates the presence of protein molecules with a secondary structure mainly in the form of a spiral (α helix), in contrast to the structure in the form of a folded sheet (β sheet) at p < 0.001‒0.05. The combined use of ³¹P NMR spectroscopy of erythrocyte suspensions and IR spectroscopy of blood serum made it possible to increase the diagnostic accuracy (96%), sensitivity (97%), and specificity (91%) in distinguishing the degrees of liver fibrosis as compared with the separate use of these techniques.

中文翻译：

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血液的核磁共振和红外光谱检查对弥漫性肝病状态的诊断

摘要

已检查了67例不同来源的弥漫性肝病的中年（48±1岁）患者。已经确定，纤维化程度的增加与6磷酸葡萄糖，单磷酸腺苷（AMP），单磷酸肌苷（IMP），焦磷酸酯和2,3-双磷酸甘油酸（ BPG）以及无机磷酸盐和磷酸肌酸，γ-，α-和β-AMP，尿苷三磷酸（UTP），Hb-和Mg-腺苷三磷酸（ATP）以及β-和α-腺苷二磷酸的共振降低（ADP）。阳性结果的预测值³¹用于肝纤维化的红细胞的1 H NMR谱图为92.3％（灵敏度为85.71％，特异性为80％）。与中度纤维化相比，重度纤维化患者血清的红外光谱图中，共振强度在1280和3190 cm ^‒1处较高，而在776、818、889、966、1399、1450处显着降低。 ，1570和1635 cm ^‒1表示存在二级结构的蛋白质分子，主要是螺旋形（α螺旋），而在p处呈折叠片状（β折叠）<0.001‒0.05。结合使用³¹与单独使用相比，红细胞悬液的P NMR光谱分析和血清的IR光谱分析可以提高区分肝纤维化程度的诊断准确性（96％），敏感性（97％）和特异性（91％）这些技术。