血清VEGF、PDGF-BB、CTGF水平与肝硬化患者肝功能分级的关系  

The relationships between levels of serum VEGF,PDGF-BB,CTGF and liver function grading in patients with liver cirrhosis

作　　者：殷洪敏 黄敏 YIN Hong-min;HUANG Min(Department of Gastroenterology,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Chongming Branch,Shanghai 202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院消化内科,上海202150

出　　处：《热带医学杂志》2020年第7期954-958,976,共6页Journal of Tropical Medicine

基　　金：上海市崇明县科学技术发展资金项目(CKY2012-13)。

摘　　要：目的探讨血清血管内皮生长因子(VEGF)、血小板衍生生长因子(PDGF)-BB、结缔组织生长因子(CTGF)水平在肝硬化发生发展中的作用,为有效防治肝硬化提供新的途径。方法选取2017年6月-2018年12月入住上海交通大学医学院附属新华医院崇明分院的肝硬化患者165例为肝硬化组,采用Child-Pugh分级标准对肝硬化患者肝功能程度进行分级评估,分为Child A级(54例)、Child B级(58例)、Child C级(53例),另选取同期本院体检健康人员60例作为对照组。采用酶联免疫吸附法(ELISA)检测受试者血清VEGF、PDGF-BB、CTGF水平。采用全自动生化分析仪检测受检者肝功能生化指标,包括天冬氨酸氨基转移酶(AST)、谷丙转氨酶(ALT)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)、白蛋白(ALB)、球蛋白(GLO)。采用Pearson法分析VEGF、PDGF-BB、CTGF水平与肝硬化患者肝功能生化指标、Child-Pugh分级评分的关系;应用ROC分析VEGF、PDGF-BB、CTGF单项及联合对肝硬化严重程度的预测价值。结果肝硬化组患者血清VEGF、PDGF-BB、CTGF、AST、ALT、ALP、GGT及GLO水平均显著高于对照组,ALB水平明显低于对照组,差异均有统计学意义(P<0.05)。肝硬化Child C级患者血清VEGF、PDGF-BB、CTGF水平均显著高于Child B级和Child A级,Child B级VEGF、PDGF-BB、CTGF水平显著高于Child A级,差异均有统计学意义(P<0.05)。VEGF、PDGF-BB、CTGF均与AST、ALT、ALP、GGT、GLO、Child-Pugh分级评分呈正相关,与ALB呈负相关(P<0.05)。血清VEGF、PDGF-BB、CTGF联合预测肝硬化严重程度的AUC为0.878,明显高于单项预测0.689、0.836、0.709。结论肝硬化患者血清VEGF、PDGF-BB、CTGF水平显著升高,可能与肝硬化患者肝功能有关,且三者联合对预测肝硬化严重程度具有重要意义。Objective To investigate the correlations between levels of serum vascular endothelial growth factor(VEGF),platelet-derived growth factor(PDGF-BB)and connective tissue growth factor(CTGF)and liver function grading,biochemical indexes in patients with liver cirrhosis.Methods 165 patients with liver cirrhosis admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Chongming Branch from June 2017 to December 2018 were selected as cirrhosis group.Child-Pugh grading criteria were used to assess the liver function of patients with cirrhosis.They were classified into Child A(54 cases),Child B(58 cases)and Child C(53 cases).Another 60 healthy persons who had physical examination in our hospital during the same period were selected as the control group.The levels of serum VEGF,PDGF-BB and CTGF were detected by enzyme-linked immunosorbent assay(ELISA).The biochemical indexes of liver function were detected by automatic biochemical analyzer,including aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),gamma-glutamyltransferase(GGT),albumin(ALB)and globulin(GLO).Pearson method was used to analyze the relationships between the levels of VEGF,PDGF-BB and CTGF and the biochemical indexes of liver function;liver cirrhosis was graded by the Child-Pugh grading score;the predictive value of VEGF,PDGFBB and CTGF for the severity of cirrhosis was analyzed by ROC.Results The levels of serum VEGF,PDGF-BB,CTGF,AST,ALT,ALP,GGT and GLO in cirrhosis group were significantly higher than those in the control group and the level of ALB was significantly lower than that in the control group(P<0.05).The levels of serum VEGF,PDGF-BB and CTGF in patients with Child C cirrhosis were significantly higher than those in patients with Child B and Child A;the levels of serum VEGF,PDGF-BB and CTGF in patients with Child B cirrhosis were significantly higher than those in patients with Child A(P<0.05).VEGF,PDGF-BB and CTGF were positively correlated with AST,ALT,ALP,GGT,GLO and the Chi

关 键 词：肝硬化 血管内皮生长因子 血小板衍生因子-BB 结缔组织生长因子 肝功能 

分 类 号：R657.31[医药卫生—外科学]