巨细胞病毒肝炎婴儿血浆生长抑素测定及其临床意义

Detection and clinical significance of plasma somatostatin in infants with cytomegalovirus hepatitis

目的测定巨细胞病毒(CMV)肝炎婴儿血浆生长抑素(SST)水平,探讨SST与肝细胞损害、肝细胞黄疸及胆道闭锁的相互关系。方法将62例CMV肝炎婴儿分为肝炎组13例(男8例,女5例)、瘀胆组15例(男8例,女7例)、肝胆组20例(男11例,女9例)、胆道闭锁组14例(男7例,女7例);另设对照组14例(男8例,女6例)、母乳性黄疸组15例(男7例,女8例)。采用放射免疫法测定各组婴儿的血浆SST水平。结果肝炎组患儿血浆SST为(55.52±4.32)ng/L,显著高于健康对照组(25.40±4.23)ng/L(P<0.01);瘀胆组患儿为(13.29±3.54)ng/L,低于健康对照组(P<0.05);肝胆组患儿为(49.24±10.41)ng/L,显著高于健康对照组(P<0.01);胆道闭锁组患儿为(18.19±4.03)ng/L,低于健康对照组(P<0.05)。结论血浆SST增高是CMV肝炎肝损害的结果,SST降低与CMV肝炎患儿血清直接胆红素(DB)升高密切相关。

Objective To determine plasma somatostatin（SST）concentration in infants with cytomegalovirus（CMV）hepatitis,and investigate the correlation between plasma SST and liver injuries,cholestasis,biliary atresia.Methods Sixty-two infants with CMV hepatitis and 15 children with breast milk jaundice admitted in Nanjing Children＇s Hospital from August 2008 to May 2009 were recruited,and 14 healthy infants were studied as control.The patients were clinically diagnosed with CMV hepatitis based on the following conditions：CMV-DNA level reached diagnostic value in serum or urine,serum CMV-IgM was positive,and antibodies of hepatitis A,B,C,D,and hepatitis E virus was negative.Serum alanine aminotransferase（ALT）level and serum direct bilirubin level（DB）were higher than those of healthy infants.The patients were divided into 4 groups：hepatitis group（n = 13,including 8 male and 5 female）,cholestasis group（n = 15,including 8 male and 7 female）,hepatitis and cholestasis group（n = 20,including 11 male and 9 female）,and biliary atresia group（n = 14,including 7 male and 7 female）.Plasma SST concentration was measured by radioimmunoassay.Results Plasma SST concentration was higher in hepatitis group（55.52 ± 4.32 ng/L）,and lower in cholestasis group（13.29 ± 3.54 ng/L）than that in normal control group（25.40 ± 4.23 ng/L）（P 0.01,P 0.05,respectively）.The difference between breast milk jaundice group and normal control group was not significant（24.10 ± 7.90 ng/L vs 25.40 ± 4.23 ng/L,P 0.05）.The concentration of plasma SST was significantly higher in hepatitis and cholestasis group（49.24 ± 10.41 ng/L）,but lower in biliary atresia group（18.19 ± 4.03 ng/L）,compared with normal control group（P 0.01,P 0.05,respectively）.Conclusions This study suggested that elevated plasma SST level might reflect liver injury,and decreased plasma SST level may be closely correlated with increased serum DB level.