肝硬化患者血浆胰岛素样生长因子结合蛋白1、3的变化及其意义  

Plasma levels of insulin-like growth factor binding protein 1,3 in patients with liver cirrhosis

作　　者：刘立新[1] 田小霞[2] 郭晓红[1] 韩德五[2] 

机构地区：[1]山西医科大学第一临床医学院科研实验中心 [2]山西医科大学肝病研究所

出　　处：《山西医科大学学报》2007年第4期302-304,332,共4页Journal of Shanxi Medical University

基　　金：山西省回国留学人员科研基金资助项目(200470);山西省科技攻关项目(051092)

摘　　要：目的研究胰岛素样生长因子结合蛋白(IGFBP)1、3在肝硬化患者中的变化及其意义。方法收集33例肝硬化患者和6名健康人的外周静脉血,采用双抗体夹心ELISA法检测血浆中IGFBP1、3和TGF-β1的水平;同时采用鲎试验三肽基质显色法测定血浆内毒素的水平;采用全自动生化分析仪常规方法测定肝脏生化指标。结果肝硬化患者血浆IGF-BP1、TGF-β1和内毒素水平与健康人相比明显增高[肝硬化患者与健康人分别为(10985.37±8374.01)ng/mlvs(3360.63±829.13)ng/ml,P<0.05;(11.87±9.90)ng/mlvs(3.30±1.08)ng/ml,P<0.05;(0.69±0.35)Eu/mlvs(0.06±0.01)Eu/ml,P<0.05];而血浆IGFBP3的水平则明显降低[(440.20±421.19)ng/mlvs(3287.97±1158.02)ng/ml,P<0.001]。血浆IGFBP3与TGF-β1呈负相关(r=-0.468,P<0.01);血浆IGFBP3与内毒素的水平也呈负相关(r=-0.355,P<0.05)。肝硬化患者血清ALT的水平明显增高[(39.30±20.46)U/Lvs(18.25±6.39)U/L,P<0.05],而血清AST、GLDH的水平与健康人比较差异无统计学意义[(47.14±30.22)U/Lvs(19.33±8.50)U/L,P>0.05;(8.62±9.29)U/Lvs(5.30±1.00)U/L,P>0.05]。结论IGFBP1、3在肝硬化的发生发展中可能起重要作用。肝硬化患者血浆IGFBP3水平的降低可能与TGF-β1、内毒素水平增高有关。Objective To observe the plasma concentration changes of IGFBP1 and IGFBP3 in patients with cirrhosis, and survey significance of IGFBP1 and IGFBP3. Methods Thirty-nine patients were recruited, including 33 cases of cirrhosis and 6 cases of healthy controls. Plasma concentrations of IGFBP1, IGFBP3 and TGF-β1 were determined by ELISA. The level of plasma endotoxin was measured by chromogenic substrate method. Liver biochemistric functions were measured by routine methods with an auto-analyzer. Results The plasma concentrations of IGFBP1, TGF-β1 and endotoxin significantly increased in cirrhotic patients compared with healthy controls [（10 985.37±8 374.01） ng/ml vs （3 360.63±829.13） ng/ml,P〈0.05;（11.87±9.90） ng/ml vs （3.30 ± 1.08） ng/ml, P 〈 0.05; （0.69 ± 0.35） ng/ml vs （0.06 ± 0.01 ） ng/ml, P 〈 0.05 ] ; but plasma concentration of IGFBP3 signifi- cantly decreased [ （440.20 ± 421.19） ng/ml vs （3 287.97 ± 1 158.02） ng/ml, P 〈 0.001 ]. There was a negative correlation between IGFBP3 and TGF-β1 （r = -0. 468,P〈0.01）,and between IGFBP3 and endotoxin（r = - 0. 355,P〈0.05）. Serum concentration of ALT significantly increased in cirrhotic patients compared with normal group [ （39.30 ± 20.46）U/L vs（ 18.25 ± 6.39）U/ L, P%0.05], but serum concentrations of AST, GLDH were not significantly increased compared with normal group [ （47.14 ± 30.22）U/L vs （19.33±8.50）U/L,P〉0.05;（8.62±9.29）U/L vs（5.30± 1.00）U/L,P〉0.05]. Conclusion IGFBP1,3 may play an important role in the emergence and development of cirrhosis. The decrease of IGFBP3 may be related to the increase of TGF-β1, endotoxin.

关 键 词：肝硬化 胰岛素样生长因子结合蛋白质类 肿瘤坏死因子β1 内毒素 

分 类 号：R575.2[医药卫生—消化系统]