摘要
目的 分别探讨肝硬化患者血清胰岛素样生长因子 (IGF) Ⅰ、IGF Ⅱ及其结合蛋白(IGFBP) 3值的改变及与肝功能状况间的关系。方法 应用免疫放射法测定 44例肝炎后肝硬化患者及38例健康对照者血清IGF Ⅰ、IGF Ⅱ、IGFBP 3值 ,比较在正常人与肝硬化以及肝功能不同ChildPugh级别中的变化。结果 IGF Ⅰ、IGF Ⅱ、IGFBP 3值与肝功能状况有明显的相关性 ,测值随着肝脏功能的减退而进行性降低 ,当IGF Ⅰ <30ng/ml,IGF Ⅱ <2 0 0ng/ml,IGFBP 3<6ng/ml时 ,则临床预后不良。IGF Ⅱ的敏感性高于IGF Ⅰ、IGFBP 3,三者与ChildPugh分级都有显著的相关性 ,联合测定有协同评估肝功能状况及提示预后的作用。结论 血清IGF Ⅰ、IGF Ⅱ和IGFBP 3测定可作为肝功能评估的重要检测指标 。
Objective To investigate the relationship between insulin like growth factor (IGF Ⅰ)、IGF Ⅱ and IGFBP 3 and Child Pugh classification in patients with liver cirrhosis and to determine the potential clinical markers of functional hepatic reserves. Methods Forty four patients with posthepatitic cirrhosis were divided into 3 groups according to disease severity (Child Pugh Score) and 38 healthy subjects severed as controls. Serum levels of IGF Ⅰ, IGF Ⅱ and IGFBP 3 were measured in these groups by immunoradiometric assay. Results Baseline IGF Ⅰ, IGF Ⅱ and IGFBP 3 levels were significantly lower in patients with cirrhosis than in controls, and the serum concentrations of IGF Ⅰ, IGF Ⅱ and IGFBP 3 were associated with the marked changes of liver function due to Child Pugh score. They all showed a significant correlation with the degree of hepatic dysfunction and dropped markedly during the progression of liver failure. The sensitivity of IGF Ⅱ is much higher than that of IGF Ⅰ and IGFBP 3. It was found that IGF Ⅰ<30 ng/ml, IGF Ⅱ<200 ng/ml, and IGFBP 3<6 ng/ml might be true predictors of a negative prognosis in patients with liver cirrhosis. Conclusions Serum IGF Ⅰ, IGF Ⅱ and IGFBP 3 may provide new markers in the assessment of liver function, and more importantly, the results indicate that the combination of IGF Ⅰ, IGF Ⅱ and IGFBP 3 with the Child Pugh score is more effective in predicting prognosis than the Child Pugl score alone.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2002年第10期601-604,共4页
Chinese Journal of Digestion
基金
日本Asahi医学发展项目
关键词
肝硬化
血清胰岛素样生长因子
结合蛋白
肝功能
放射免疫法
Liver cirrhosis
Insulin like growth factor
Insulin like growth factor Ⅰ binding protein 3
Liver function
