乙型肝炎肝硬化患者血清IGF-Ⅰ水平与肠道屏障功能损害的关系分析  

Relationship between serum IGF-I levels and intestinal barrier damage in patients with hepatitis B cirrhosis

作　　者：周文浩[1] 蒋晓忠[1] 王昌松[1] 黄斌[1] Zhou Wenhao;iang Xiaozhong;Wang Changsong;HUANG Bin(Department of Hepatobiliary Surgery,Second People's Hospital,Yibin 644000,Sichuan Province,China)

机构地区：[1]四川省宜宾市第二人民医院肝胆胰外科,644000

出　　处：《实用肝脏病杂志》2018年第4期585-588,共4页Journal of Practical Hepatology

摘　　要：目的研究乙型肝炎肝硬化患者血清胰岛素样生长因子Ⅰ(IGF-Ⅰ)水平与肠道屏障功能损害的关系。方法 2015年1月~2017年1月我院诊治的乙型肝炎肝硬化患者107例,其中Child-Pugh A级35例,Child-Pugh B级42例,Child-Pugh C级30例,另选同期健康志愿者40例。采用酶联免疫吸附法检测血清IGF-Ⅰ水平,采用化学比色法检测血清二胺氧化酶(DAO),采用改良酶学分光光度法检测血清D-乳酸,采用显色基质鲎实验法检测血清内毒素,采用高压液相色谱分析法检测尿液乳果糖/甘露醇(L/M)排出比。结果健康人血清IGF-Ⅰ水平为(217.1±40.2)ng/ml,显著高于Child-Pugh A级肝硬化患者的(180.3±33.4)ng/ml、B级的(152.4±26.5)ng/ml或C级的(126.9±21.8)ng/ml(P<0.05);健康人血清DAO、D-乳酸、内毒素和尿液L/M比值分别为(2.5±0.5)U/ml、(7.1±1.3)μg/ml、(0.4±0.1)EU/ml和(6.3±1.1)%,显著低于Child-Pugh A级肝硬化患者的(3.3±0.7)U/ml、(9.0±1.6)μg/ml、(0.6±0.1)EU/ml和(9.2±1.7)%或B级的(4.6±0.9)U/ml、(11.2±1.9)μg/ml、(0.8±0.1)EU/ml和(12.6±2.3)%或C级的(5.8±1.0)U/ml、(13.4±2.4)μg/ml、(1.1±0.2)EU/ml和(15.7±2.8)%(P<0.05);乙型肝炎肝硬化患者血清IGF-Ⅰ与DAO、D-乳酸、内毒素和尿液L/M比值均呈负相关(r=-0.845、r=-0.808、r=-0.867、r=-0.839,P<0.01)。结论乙型肝炎肝硬化患者存在肠道屏障功能损害,检测血清IGF-Ⅰ水平有一定的判断意义。Objective To investigate the relationship between serum insulin-like growth factor I(IGF-I)levels and intestinal barrier damage in patients with hepatitis B liver cirrhosis.Methods 107 patients with hepatitis B liver cirrhosis(35 were of Child-Pugh class A,42 of Child-Pugh class B and 30 of Child-Pugh class C)were recruited in our hospital between January 2015 and January 2017,and 40 healthy volunteers were included at the same period serving as control.Serum IGF-I,diamine oxidase(DAO),D-lactic acid and endotoxin,as well as excretion ratio of urine lactulose/mannitol(L/M)were detected.Results Serum IGF-I level in the healthy control was(217.1±40.2)ng/ml,significantly higher than[(180.3±33.4)ng/ml in patients with Child-Pugh class A,(152.4±26.5)ng/ml in Child-Pugh class B or(126.9±21.8)ng/ml in Child-Pugh class C,all P<0.05);serum DAO,D-lactic acid and endotoxin levels,and L/M ratio in the healthy control were(2.5±0.5)U/ml,(7.1±1.3)μg/ml and(0.4±0.1)EU/ml,and(6.3±1.1)%,significantly lower than[(3.3±0.7)U/ml,(9.0±1.6)μg/ml and(0.6±0.1)EU/ml,and(9.2±1.7)%in patients with Child-Pugh class A,or(4.6±0.9)U/ml,(11.2±1.9)μg/ml and(0.8±0.1)EU/ml,and(12.6±2.3)%in Child-Pugh class B or(5.8±1.0)U/ml,(13.4±2.4)μg/ml and(1.1±0.2)EU/ml,and(15.7±2.8)%in Child-Pugh class C,all P<0.05];serum IGF-I level in patients with liver cirrhosis was negatively correlated with serum DAO,D-lactic acid,endotoxin and urine L/M ratio(r=-0.845,r=-0.808,r=-0.867,r=-0.839,P<0.01).Conclusion Patients with hepatitis B liver cirrhosis have damaged intestinal barrier,and serum IGF-I level might reflect it in this setting.

关 键 词：肝硬化 乙型肝炎 胰岛素样生长因子Ⅰ 肠道屏障功能 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]