血浆半乳糖凝集素-3水平对慢加亚急性肝衰竭预后的判断作用  

Relationship between serum galectin-3 levels and mortality of subacute on chronic liver failure

作　　者：郑以山[1] 吴宗盛[1] 董磊[2] 张丽[1] 肖玲燕[1] 史东阳[1] 杨永峰[1] 

机构地区：[1]东南大学附属第二医院重症医学科,南京210003 [2]南京大学生命科学院

出　　处：《中华肝脏病杂志》2014年第4期295-298,共4页Chinese Journal of Hepatology

基　　金：南京市医学科技发展项目（YKK12116）;南京市卫生青年人才培养工程（QRX11233）

摘　　要：目的探讨血清半乳糖凝集素（galectin）-3水平升高与肝衰竭患者预后的关系。方法对2010年1月至2011年12月住院的慢加亚急性肝衰竭患者55例，给予内科综合治疗并随访6个月，所有患者抽取外周静脉血检测galectin-3水平，选取同时期慢性乙型肝炎患者30例和健康对照者30名作为对照。计量资料两组间比较采用t检验或Mann-WhitneyU检验，多组间比较采用方差分析；计数资料比较采用x^2检验。结果健康对照组、慢性乙型肝炎组和肝衰竭组患者血清galectin-3水平分别为0．0423（0．0192，0．0800）ng／ml、0．3842（0．1152，0．5807）ng／ml、0．5834（0．0454，0．8275）ng／ml，肝衰竭组患者血清galectin-3水平显著高于其他两组（P〈O．01）；慢性乙型肝炎组患者血清galectin-3水平高于健康对照组（P〈0．01）。肝衰竭死亡组（n=28）血清galectin-3水平为0．3657（0．1152，0．4987）ng／ml，低于生存组（n=27）的0．7933（0．1786，1．3055）ng／ml，差异有统计学意义（t=6．710，P〈0．01）。受试者工作特征曲线下面积为0．766，临界值为0．2465ng／ml，大于界值组生存率为62．9％（17／27），小于界值组生存率为47．4％（9／19），x^2=5．238，P〈0．05。结论Galectin-3上调可能是促进肝组织修复的保护性因素，血清galectin-3水平升高与肝衰竭患者的不良预后密切相关。Objective To study the correlation between clinically detected serum galectin-3 levels and prognosis of liver failure. Methods Fifty-five patients diagnosed with liver failure were administered a combined modality therapy and followed up until death or for 6 months. Fifty-five patients with liver failure were administered a combined modality therapy and followed up until death or for 6 months. In addition, 30 patients with chronic hepatitis B （CI-IB） and 30 healthy volunteers were matched for use as controls. Serum galectin-3 levels were detected at baseline and last follow-up visit and compared between groups by statistical analysis. Results At baseline, the CI-IB group had a significantly higher level of serum galectin-3 than the healthy control group （F = 2.701, P 〈 0.01）. However, the galectin-3 level5 of the liver failure group was significantly higher than that of both the CI-IB group （F= 8.121,P 〈 0.01） and the healthy control group （F= 11.231,P 〈 0.01）. When patients within the liver failure group were divided by survival and death occurring during the 6-month follow-up period, the patients who died （n = 28） were found to have a significantly higher level of serum galectin-3 than the surviving patients （n = 27） （P 〈 0.01）. The area under the curve of ROC curve is 0.766, and cut offvalue is 0.246 5 ng/ml. Conclusion The level of serum galectin-3 is positively correlated with risk of death in patients with liver failure. Up-regulation of galectin-3 may act as a protective factor in patients with severe liver injury.

关 键 词：肝功能衰竭 预后 血清半乳糖凝集素-3 

分 类 号：R575.3[医药卫生—消化系统]