血清VEGF、CTGF和TGF-β1水平检测对CHB肝硬化患者肝功能Child-Pugh分级和疾病预后的评估价值  

The evaluation value of serum VEGF,CTGF and TGF-1 levels in child-pugh grade of liver function and disease prognosis in patients with CHB cirrhosis

作　　者：张婷焱 周宝勤 顾春燕[2] ZHANG Ting-yan;ZHOU Bao-qin;GU Chun-yan(Department of Infectious Diseases,haian hospital affiliated to nantong university(Jiangsu Haian,226600),China;Department of oncology,the third people's hospital of nantong(Jiangsu Nantong,226006),China)

机构地区：[1]南通大学附属海安医院感染病科,江苏海安226600 [2]南通市第三人民医院肿瘤科

出　　处：《中西医结合肝病杂志》2022年第5期440-442,446,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：南通市2018年度市级科技计划项目(No.JCZ18046)。

摘　　要：目的:分析血清血管内皮生长因子(VEGF)、结缔组织生长因子(CTGF)和转化生长因子-β1(TGF-β1)检测对慢性乙型肝炎(CHB)肝硬化患者肝功能Child-Pugh分级和疾病预后的评估价值。方法:选择140例CHB肝硬化患者按照肝功能Child-Pugh分级分成A级组、B级组和C级组,同期选择CHB患者和HBV携带者各45例作为对照,检测血清VEGF、CTGF和TGF-β1等细胞因子水平,及透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)和Ⅳ型胶原(Ⅳ-C)等肝纤维化指标水平,观察CHB肝硬化组3个亚组的门静脉压力和脾脏厚度,6个月内的消化道出血和死亡率发生等预后指标。结果:CHB肝硬化组患者血清VEGF、CTGF和TGF-β1等细胞因子水平均高于CHB患者和HBV携带组患者(P<0.05)。在CHB肝硬化组3个亚组中,Child-Pugh C级组的患者血清VEGF、CTGF、TGF-β1水平,HA、LN、PC-Ⅲ、Ⅳ-C水平,以及门静脉压力、脾脏厚度、消化道出血率和死亡率等指标,均显著高于Child-Pugh A级和Child-Pugh B级组(P<0.05)。结论:血清VEGF、CTGF和TGF-β1等细胞因子水平检测可作为CHB肝硬化患者肝功能Child-Pugh分级和疾病预后评估的重要指标,临床价值应用较高。Objective:To analyze the correlation between serum vascular endothelial growth factor(VEGF),connective tissue growth factor(CTGF),and transforming growth factor-1(TGF-1)on child-pugh grading of liver function in patients with chronic hepatitis B(CHB)cirrhosis and the evaluation value of disease prognosis.Methods:A total of 140 patients with CHB child-pugh,classification according to the liver function of patients with liver cirrhosis were divided into class A and class B group and C group,at the same time choose CHB patients and HBV carriers all 45 cases as control,detection of serum VEGF,CTGF and TGF-beta 1 cytokine levels,hyaluronic acid(HA),mucin layer(LN),type Ⅲ before collagen(PC-Ⅲ)and collagen type Ⅳ(Ⅳ-C)of liver fibrosis indexes such as level;Prognostic indicators such as portal venous pressure,spleen thickness,gastrointestinal bleeding and mortality within 6 months were observed in the three subgroups of CHB cirrhosis.Results:The serum levels of VEGF,CTGF,and TGF-1 in the CHB cirrhosis group were higher than those in the CHB patients and the HBV-carrying group(P<0.05).In the CHB cirrhosis group three subgroups,child-pugh C group of serum VEGF,CTGF,TGF-beta 1 level,HA,LN,PC-Ⅲ,Ⅳ-C level,and the portal vein pressure,the thickness of spleen,gastrointestinal bleeding rate and mortality indicators,were significantly higher than that of the Child-Pugh,class B and child-pugh,A grade group(P<0.05).Conclusion:Serum levels of cytokines such as VEGF,CTGF,and TGF-1 can be used as an important indicator for child-pugh grading of liver function and disease prognosis assessment in patients with CHB cirrhosis,with high clinical value.

关 键 词：慢性乙型肝炎 肝硬化 VEGF CTGF TGF-Β1 CHILD-PUGH分级 预后 

分 类 号：R575.2[医药卫生—消化系统]