摘要
目的探讨肝硬化失代偿患者血清胰岛素样生长因子(IGF-Ⅰ、IGF-Ⅱ)和血钠的变化,对肝硬化失代偿患者预后评估的意义。方法应用免疫放射检测60例肝硬化失代偿患者及60例健康对照者血清IGF-Ⅰ、IGF-Ⅱ的水平,同时应用自动生化分析仪同步检测肝硬化患者血电解质和肝功能,比较在正常人与肝硬化以及肝功能不同Child-pugh级别中的变化;并进行6个月的随访,记录存活情况。结果肝硬化失代偿患者血清IGF-Ⅰ、IGF-Ⅱ水平显著低于健康对照组(P<0.001),血清IGF-Ⅰ、IGF-Ⅱ和血钠的水平与肝功能状态有一定的相关性,其测定值随肝功能的减退而降低,三者在Child-pugh分级A、C二组间差异有显著的统计学意义(P<0.01);短期随访显示肝硬化病死组的血清IGF-Ⅰ、IGF-Ⅱ和血钠水平显著低于存活组,其中血清IGF-Ⅰ两组间差异有统计学意义(P<0.05)。结论血清IGF-Ⅰ、IGF-Ⅱ和血钠的测定可作为肝功能评估的重要检测指标,其中血清IGF-Ⅰ的敏感性高于IGF-Ⅱ和血钠,联合测定有协同评估肝功能状态及提示近期预后的作用。
Objective To investigate how the variation of serum insulin- like growth factor （IGF-Ⅰ、IGF-Ⅱ）and serum sodium could influence the prognosis assessrnent in patients with decomptm satire liver cirrhosis. Methods Sixty patients with severe liver cirrhosis were divided into 3 groups according to disease severity （Child Pugh score） and 60 healthy people severed as controls, Serum levels of IGF-Ⅰ、IGF-Ⅱ were measured in these groups by radioinununodetection, and electrolytes and liver function were also measured simultaneously by the machine of auto - biochemistry - anlysis , the difference of those data in different group as well as the change of these data in people with different liver function according to （Child Pugh score） were analysed .Then the patients＇ were followed up for six months and the survival were recorded. Results Serum levels of IGF-Ⅰand IGF-Ⅱ were significantly lower in patients with liver cirrhosis than in controls （ P 〈 0.001 ）, and the serum concentrations of IGF-Ⅰ、IGF-Ⅱ and serum sodium were associated with the marked changes of liver function. They all showed a significantly correlation with the degree of hepatic dysfunction and dropped during the progression of liver failure, And the diversity between Child - Pugh score A and C played an important role in statistics（ P 〈 0.01 ）. The short - time follow -up showed that serum levels of IGF-Ⅰ、IGF-Ⅱand serum sodium were significantly lower in the death group with cirrhosis than in controls. The diversity between two groups of serum IGF-Ⅰ. made a marked significance in statistics （ P 〈 0. 05）. Conclusion Scram IGF-Ⅰ、IGF-Ⅱ and serum sodium may provide new markers in the assessment of liver function. The sensitivity of IGF-Ⅰ is much higher than that of IGF-Ⅱ and serum so（hum. And more importantly, the results indicate that the combination of IGF-Ⅰ、IGF-Ⅱ and serum sodium play an impmtant role in the assessment of liver function and short - time prognosis.
出处
《浙江临床医学》
2006年第3期243-244,共2页
Zhejiang Clinical Medical Journal
关键词
肝硬化
血清胰岛索样生长因子
血清钠
肝功能
Liver cirrhosis Insulin- like growth factor serum sodium Liver function
