胰岛素样生长因子-Ⅰ在慢性肝病患者血清中的测定及意义

Detection and significance of Insulin-like Growth Factor-Ⅰ in serum of patients with chronic hepatic diseases

目的探讨胰岛素样生长因子-Ⅰ在慢性肝病患者血清中的测定及临床意义。方法应用酶联免疫吸附法,检测IGF-Ⅰ在慢性肝病患者及健康体检者血清中的表达,同时应用核酸扩增荧光定量检测法测定慢性乙型肝炎患者血清HBV-DNA水平。结果不同程度肝病患者血清中IGF-Ⅰ水平差异有显著性,慢性乙肝(轻、中、重度)组血清游离IGF-Ⅰ水平均高于肝硬化组、原发性肝癌组及正常对照组(P<0.01),肝硬化组、原发性肝癌组患者IGF-Ⅰ水平较对照组降低(P<0.01);在肝硬化组按Child-Pugh分级,IGF-Ⅰ从A级组到B级组、到C级组逐渐下降(A级组与B级组,B级组与C级组比较,均有显著性差异,P<0.01),慢性乙型肝炎组IGF-Ⅰ水平随着HBV-DNA定量的升高而升高,明显高于HBV-DNA阴性组及正常对照组。结论IGF-Ⅰ是在肝脏疾病的发展过程中判断肝细胞功能不良的重要指标。检测IGF-Ⅰ对肝病患者尤其是判断肝硬化进展情况有一定的意义。

Objective Investigate the determination and clinical significance of insulin-like growth factor- Ⅰ in serum of patients with chronic hepetic diseases. Methods Using enzyme-linked immunosorbent assay to test IGF- Ⅰ in patients with chronic hepatic diseases and healthy cases, while HBV-DNA quantity of chronic hepatitis B patients are tested by fluorescence quantitative detection of nucleic acid amplification. Results There are statistically significant differences in IGF-Ⅰ levels of patients with chronic hepetic diseases,IGF-Ⅰ in group of chronic hepatitis B （mild,moderate,severe） is higher than that in liver cirrhosis group,primary liver cancer group and the normal control group （ P 〈 0.01）. IGF- Ⅰ in serum of liver cirrhosis and primary liver cancer is lower than that in norreal control group （ P 〈 0.01） ,In liver cirrhosis group classified by the Child-Pugh,IGF- Ⅰ levels gradually decrease from A to B and C. （comparison, there are significant differences between A and B, B and C, P 〈 0.01）, chronic hepatitis B group with IGF- Ⅰ levels of HBV-DNA quantitative increase exponentially, significantly higher than that of HBV-DNA negative group and the normal control group. Condusion IGF- Ⅰ can be a marker of hcpatocellular dysfunction on the progress of liver diseases. It is useful to detect IGF- Ⅰ level for diagnosing and determining prognosis of patients with liver diseases and particular those with liver cirrhosis.