血清及肝组织胰岛素样生长因子1与慢性乙型肝炎及肝硬化肝细胞损伤的关系

Relationship of insulin-like growth factor-1 and hepatocyte damage in chronic virus B hepatitis and liver cirrhosis

目的探讨胰岛素样生长因子1(IGF-1)在慢性乙型肝炎和肝硬化患者肝细胞损伤中的作用及其意义。方法采用酶联免疫吸附(ELISA)法检测39例慢性乙型肝炎、37例乙型肝炎肝硬化及12例健康供血者血清IGF-1,其中26例肝组织标本行IGF-1的免疫组化染色,并采用多媒体彩色图文分析系统进行图像定量分析。结果慢性肝炎患者随着肝细胞损害程度的加重血清IGF-1逐渐降低,慢性肝炎轻、中、重度患者IGF-1分别为(173.18±49.50)μg/L(、101.36±35.73)μg/L、(87.63±20.19)μg/L(P<0.01);肝硬化组随着肝功能代偿能力的减退血清IGF-1明显下降,Child-Pugh A、B、C分别为(89.76±27.93)μg/L、(41.32±16.14)μg/L(、26.88±9.87)μg/L(P<0.01);炎症活动0级(G0)至G3IGF-1的光密度逐渐增加,但差异无统计学意义。结论血清IGF-1水平及肝组织IGF-1的表达强度在一定程度上反映肝细胞的炎症坏死程度及肝脏合成储备功能,可作为预测病情预后的可靠指标。

Objective To study the change and clinical significance of insulin-like growth factor-1 in chronic virus B hepatitis and liver cirrhosis. Methods Enzyme linked immunosorbent assay（ELISA） method was used to examine the serum insulin-like growth factor-1（IGF-1） of 39 chronic hepatitis B,37 hepatic cirrhosis patients and 12 healthy blood donors; Among them, 26 hepatic tissues were processed by using immunohistochemistry dyeing of IGF-1. Results Serum IGF-1 level was decreased gradually following the increase of inflammation activity in the chronic hepatitis group,mild,medium and serious degree respectively as （173.18± 49.50）μg/L, （101.36 ± 35.73）μg/L, （87.63 v 20.19）μg/L（ P 〈0.01）. The serum IGF-1 level decreased obviously accompanying the decrease of liver functional compensation ability in the cirrhosis group,Chiid-Pugh A ,B,C respectively as （89.76±27.93）μg/L, （41. 32v16.14）μg/L, （ 26.88 ±9.87）μg/L （ P 〈 0.01 ）. The photo density o f IGF-1 was iner＇ease g radually from Go to G3. Conclusion Serum IGF-1 level and expression intensity of liver tissue IGF-1 had reflected the hepatoeellular inflammation-necrotic degree and liver synthetic reserve function. It can be used as a reliable indicator to predict the pathogeneti condition and prognosis of chronic hepatitis and cirrhosis patients.