巨细胞病毒肝炎婴儿外周血生长抑素、肠血管活性多肽与γ谷氨酰转肽酶水平的相关性  

Correlations of Plasma Somatostatin or Vasoactive Intestinal Polypeptides Level and Serum γ-Glutamyltransferase Level in Infantile Cytomegalovirus Hepatitis

作　　者：杨辉[1] 金玉[1] 郝理华[1] 李玫[1] 何祖蕙[1] 

机构地区：[1]南京医科大学附属南京儿童医院消化内科,南京210008

出　　处：《实用儿科临床杂志》2011年第19期1500-1502,共3页Journal of Applied Clinical Pediatrics

基　　金：南京医科大学科技发展基金面上项目(08NMUM039)

摘　　要：目的探讨巨细胞病毒(CMV)肝炎婴儿血浆生长抑素(SST)、肠血管活性多肽(VIP)水平与血清γ谷胺酰转肽酶(γ-GT)的相关性,了解其在CMV肝炎婴儿持续性胆汁瘀积的诊断和鉴别诊断中的意义。方法收集本院CMV肝炎婴儿60例。临床确诊依据CMV感染诊疗方案,即具备以下条件:(1)外周血或尿CMV-DNA和CMV-IgM呈阳性,甲型肝炎、乙型肝炎、丙型肝炎、丁型肝炎和戊型肝炎抗体检测均为阴性;(2)外周血ALT和结合胆红素(DB)高于正常值上限。根据最初的DB高低分组,≤136.8μmol.L-1(瘀胆型肝炎Ⅰ组)22例;>136.8μmol.L-1(瘀胆型肝炎Ⅱ组)20例,全部具备条件(1)和(2),影像学检查排除胆道闭锁(BA)。BA组18例全部具备条件(1)和(2),并有B超检测胆道不显影及锝99放射扫描显像法肠道不显影。健康对照组14例。血浆SST或VIP水平测定采用放射免疫法,而血清γ-GT水平测定采用常规生物化学法。结果健康对照组、瘀胆型肝炎Ⅰ组和瘀胆型肝炎Ⅱ组SST水平与γ-GT水平无相关性(r=0.180,P>0.05);3组VIP水平与γ-GT水平呈显著正相关性(r=0.383,P<0.05)。健康对照组和BA组SST、VIP水平分别与γ-GT水平均呈显著负相关(r=-0.743,P<0.01;r=-0.918,P<0.01)。结论 CMV肝炎患儿外周血VIP水平可作为反映肝内胆汁瘀积的良好指标。此外,外周血SST或VIP水平可作为瘀胆型肝炎和BA鉴别诊断的敏感指标之一。Objective To investigate the correlations between plasma somatostatin （SST） or vasoactive intestinal polypeptides （VIP） level and serum gamma glutamyltransferase（ γ - GT） in infants with cytomegalovirus（CMV） hepatitis and further to evaluate the diagnostic and differential diagnostic value of plasma SST and VIP level in persistent infantile jaundice. Methods A total of 60 infants with CMV hepatitis in Nanjing Children＇s Hospital Affiliated to Nanjing Medical University from Aug. 2008 to Dec. 2009,clinical confirmed CMV hepatitis based on the following conditions ： （ 1 ） Examination of CMV - DNA level in serum or urine and serum CMV - IgM level were positive, and the examinations of hepatitis A virus antibodies, hepatitis B virus antibodies, hepatitis C virus antibodies, hepatitis delta virus antibodies and hepatitis E virus antibodies were negative. （2）Serum alanine aminotransferase （ALT） level and serum direct bilirubin level（ DB ） were higher than those of healthy infants. According to the level of DB ,42 infants with CMV hepatitis which meet condition（ 1 ） and condition（ 2 ） while without biliary atresia（BA） excluded by imaging examination were divided into 2 groups：cholestatic hepatitis I group containing 22 cases with serum DB ≤ 136.8 umol · L-1, and cholestatic hepatitis II group containing 20 cases with serum DB 〉 136.8 umol · L-1. Eighteen infants with BA totally meet condition （ 1 ） and condition （2）, and with BA proved by imaging examination. Normal control group contained 14 cases of healthy infants. The plasma SST or VIP concentration of infants with CMV hepatitis, and healthy infants （healthy control group）were measured by radioimmunoassay and the serum γ- GT level was measured by biochemistry method. Results Positive correlation was found between plasma VIP level and serum γ - GT level in healthy control group, cholestatic hepatitis I group and cholestatic hepatitis II group （r = 0. 383, P 〈 0. 05 ）, while plasma SST had no

关 键 词：生长抑素 肠血管活性多肽 γ谷氨酰转肽酶 瘀胆型肝炎 胆道闭锁 

分 类 号：R725.1[医药卫生—儿科]