肝硬化患者血清胰岛素样生长因子-1的变化及其临床意义

Clinical significance of serum insulin-like growth fuctor-1(IGF-1) in liver cirrhosis

目的:研究肝硬化患者血清胰岛素样生长因子-1(IGF-1)的变化及其临床意义。方法:肝硬化患者79例,根据Child-Pugh评分分为3组,A级组21例,B级组29例,C级组29例,另选取20例正常体检者为正常组。Child-Pugh A、B、C级肝硬化患者再根据其入院症状分为消化道出血组与非出血组。ELISA法测定血清IGF-1值,全自动生化分析仪常规方法测定肝脏生化指标。结果:肝硬化A、B、C级组患者血清IGF-1水平与正常组比较均明显降低(P<0.01);肝硬化A、B、C级组间比较IGF-1水平亦有明显差异(P<0.01或P<0.05);Child-Pugh A、B、C级肝硬化患者消化道出血组院者与非出血组IGF-1值无明显差异(P>0.05)。结论:肝硬化患者IGF-1水平明显下降,而且其下降程度与肝脏病变程度有关;IGF-1可作为肝硬化患者肝脏功能及预后的评价指标,但是不能作为预测上消化道出血概率的指标。

Objective To investigate the clinical significance of serum insulin-like growth fuctor-1 （IGF-1） in patients with liver cirrhosis. Methods 79 patients with liver cirrhosis were divided into 3 groups according to severity of cirrhosis （Child-Pugh score） and 20 healthy subjects served as controls. Patients in each serious group of cirrhosis were divided into 2 groups according to whether they got a gastrointestinal hemorrhage or not. Serum IGF-1 levels were measured by enzyme-linked immunosorbent assay （ELISA）. Results Serum IGF-1 levels were significantly lower in patients with cirrhosis than in controls （P 〈 0.01 ）, and serum concentrations of IGF-1 were associated with the severity of cirrhosis. Serum IGF-1 levels in patients with gastrointestinal hemorrhage had no difference from those without gastrointestinal hemorrhage（P〉O.05）. Conclusion Serum IGF-1 levels are associated with the severity of liver dysfunction, and dropped sharply during the progression of liver dysfunction. It is a good potential index to value the severity of liver cirrhosis, but has no value to be used to estimate gastrointestinal hemorrhage risk.