67 patients (mean age 48 ± 1 year) with diffuse liver diseases of various origins were 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, 2,3-DPH and a decrease in the resonances of inorganic phosphates and phosphocreatine, γ-, alpha- and beta- ATP, -UTP, Hb- and Mg-ATP, as well as beta- and alpha-ADP. The predictive value of a positive result of erythrocyte 31P NMR spectroscopy for liver fibrosis is 92.3% (sensitivity 85.71%, specificity 80%). In the IR spectra of the blood serum of patients with severe fibrosis, in contrast to moderate fibrosis, the resonance intensity is higher at 1280, 3190 and significantly lower at 776, 818, 889, 966, 1399.1450, 1570, 1635 cm-1, which indicates the presence of protein molecules with a secondary structure mainly in the form of a helix (alpha-helix) compared with the structure in the form of a folded sheet (beta-sheet) (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 diagnostic accuracy (96%), sensitivity (97%) and specificity (91%) in distinguishing between degrees of liver fibrosis in contrast to the isolated use of these methods.
Использование ЯМР и ИК спектроскопии для исследования крови в целях диагностики стадии заболевания при диффузной патологии печени