人肝再生增强因子在肝衰竭患者血清及肝组织中的表达及其意义

Expression and role of augmenter of liver regeneration in patients with hepatic failure

目的探讨人肝再生增强因子（ALR）在肝衰竭患者血清及肝组织中的表达水平及其意义。方法制备Balb／c小鼠来源的人ALR蛋白多克隆抗体并纯化其IgG组分，以该抗体通过酶联免疫吸附法建立ALR浓度与吸光值的标准曲线。获取18例肝衰竭患者、24例慢性乙型肝炎患者及10名正常人血清，比较其血清ALR水平差异，实时荧光PCR法比较各组患者肝组织ALR mRNA表达水平差异。据资料不同采用Bonferroni或LSD检验进行统计学分析。结果Western blot结果发现人ALR蛋白多克隆抗体能特异性结合人ALR蛋白，酶联免疫法检测结果发现其在一定的ALR浓度范围内有良好的线性关系。l8例肝衰竭患者中，6例好转出院的患者血清ALR水平为（1613．5±369．6）pmol／ml，高于12例肝功能恶化、死亡或不得不接受肝移植患者的（462．3±235．8）pmol／ml（t=11．21，P〈0．05）；慢性乙型肝炎患者为（969．2±332．5）pmol／ml，与正常人的（806．9±240．8）pmol／ird差异无统计学意义（t=2．17，P〉0．05）。5例接受肝移植的患者肝组织ALR mRNA表达水平为（3．45±0．38）log10拷贝／ul，低于慢性乙型肝炎患者的（4．37±0．15）log 10拷贝／ul及正常供体的（4．31±0．10）log 10拷贝／ul（P〈0．05），而后两者差异无统计学意义（P〉0．05）。结论血清ALR水平反映了肝脏ALR mRNA表达水平，其在预测慢加急性肝衰竭患者的预后方面有一定意义。

Objective To investigate the expression and role of augmenter of liver regeneration （ALR） in hepatic failure. Methods ALR polyclonal antibody was prepared and purified. Serum ALR in patients with hepatic failure, chronic hepatitis B and healthy persons were quantified by ELISA, ALR mRNA in hepatic tissues were quantified by real-time PCR. Results Different serum ALR levels foreshowed different outcomes for hepatic failure patients： The liver function was restored in 6 patients with higher ALR level [（1613.5 ± 369.6） pmol/ml], and the liver function was deteriorated in 12 patients with lower ALR level [（462.3 ± 235.8） pmol/ml]. ALR level in patients with chronic hepatitis B [（969.2 ± 332.5） pmol/ml] was similar to that in healthy persons [（806.9 ± 240.8） pmol/ml]. ALR mRNA level in hepatic failure patients receiving OLT （103.45 copies/ul） was lower than that in chronic hepatitis B patients （104.37 copies/ul） and healthy persons （104.31 copies/ul）, ALR mRNA level in chronic hepatitis B and healthy persons was similar. Conclusion These findings suggest serum ALR level reflected ALR mRNA level in liver and is helpful in estimating the survival time of patients with hepatic failure.