肝硬化患者外周血G-CSF及其受体表达状况研究

Study on Peripheral Blood G-CSF and the Expression of G-CSF Rece ptor in Liver Cirrhosis Patients.

目的探讨肝硬化患者外周血粒细胞集落刺激因子(G-CSF)及其受体表达状况及临床意义。方法采用酶联免疫吸附试验(ELISA)分析38例失代偿肝硬化患者血清G-CSF变化,用流式细胞术(FlowCytometry,FCM)同步对外周血粒细胞G-CSF受体表达状况进行了研究。结果肝硬化粒细胞减少患者血清G-CSF水平(289±56.30pg/ml,x-±s,n=20)较健康人(106±23.94pg/ml,n=15)及粒细胞正常的肝硬化患者(113±44.85pg/ml,n=8)明显升高(P<0.05)。在合并急性细菌感染肝硬化患者血清G-CSF更为显著上升,达708±440.28pg/ml,明显高于非感染组(P<0.01),感染控制后血清G-CSF水平明显下降。本研究结果同时提示,以上各组肝硬化患者外周血粒细胞G-CSF受体表达阳性百分率未发生相应变化。结论肝硬化患者粒细胞减少后造血因子G-CSF普遍升高。G-CSF显著上升,对肝硬化粒细胞减少患者合并急性细菌感染的判断有很好的临床实用价值。G-CSF受体表达状况很可能亦参与肝硬化粒细胞减少发病机制,值得进一步研究。

Objective To explore the relationships between peripheral blood G - CSF and the expression of G - CSF Receptor in liver cirrhesis patients with granulocytepenia.Metheds Plasma G- CSF levels in sera of 38 decompensated cirrhosis patients were tested by using enzyme - Linked immune sorbent assay （ELISA）, and the expression of peripheral blood G- CSF receptor on the granulocyte was investigated by flow cytemetry （FCM） in the meantime. Results Higher Plasma G- CSF levels （289 ± 56.30pg/ml, x±s, n = 20） were found in liver cirrhosis patients with graradocytepenia as compared with healthy control subjects （ 106 ± 23.94pg/ml, n = 15） and those liver cirrhosis patients with norreal granulocyte counts （113 ± 44.85pg/ml, n = 8） （P〈0.05） . Significantly elevated serum G- CSF levels （708 ± 440.28pg/ml, n = 10） were also found in liver cirrhosis patients with granulocytepenia when they complicated with acute infection compared to the above no - infection groups （ P 〈 0. 01）, and those declined markedly when the infection were controlled. This study also suggested that the positive percent expression of G- CSF receptor on peripheral blood granulocyte didn＇t change accordingly between four groups in liver cirrhosis patients with granulocytepenia.Conclusiom It＇s a common phenomenon that senun G- CSF levels increase in liver cirrhosis patients complicated with granulocytepenia. Significantly elevated serum G - CSF concentrations can be used as an indicator on clinical practice to diagnose liver cirrhosis patients with granulocytepenia complicated with acute infection. The expression levels of G - CSF receptor may also attribute to the pathogenesis of granulocytepenia in liver cirrhosis and it is worth of investigation further.