肝硬化血清胰岛素样生长因子-Ⅰ与肝功能和数字连接试验的关系

Relationship between insulin-like growth factor Ⅰ and liver functionand number connection test

目的观察肝硬化患者血清胰岛素样生长因子-1(IGF-1)的浓度,同时进行数字连接试验(NCT)测定,比较IGF-1与NCT、肝功能不同Child分级的关系,探讨IGF-1与肝硬化预后及亚临床肝性脑病(SHE)的相关性。方法夹心免疫法测定45例肝硬化患者和34例正常对照者血清IGF-1浓度,肝硬化组另行NCT测定及Child-pugh分级。结果肝硬化组血清IGF-1浓度(68±66)μg·L^(-1)明显低于健康对照组(246±94)μg·L^(-1),P<0.01.且随着Child A、B、C分级的升高而递减,Child A级血清IGF-1浓度(135±80)μg · L^(-1),明显高于Child B级(44±29)μg·L^1、Child C级(27±10)μg·L^(-1),P<0.01.Child B与 Child C级血清IGF-1浓度虽有递减,但无统计学差异(P>0.05).NCT低于66s组患者的血清IGF-1浓度(78±16)μg·L^(-1),明显高于NCT高于66s组患者的血清IGF-1浓度(18±4)μg·L^(-1),P<0.01。结论肝硬化患者血清IGF-1浓度与肝功能Child-pugh分级、与NCT测值密切相关,提示IGF-1与肝硬化严重程度及肝硬化亚临床肝性脑病的发生有关。

AIM To study the relationship between insulin-like growth factor I (IGF-I) and cirrhotic prognosis and subclinical hepatic encepalopathy (SHE). METHODS Serum IGF-I concentration was detected by immunoassay in 45 cases of cirrhosis and 34 healthy persons, Child-Pugh was evaluated and NCT was done with a standard test sheet in cirrhosis. RESULTS The serum IGF-I concentration in cirrhosis was (68±66)μg.L^(-1), being significantly lower than that in healthy controls (246±94)μg·L^(-1) p<0.01. It was (135±80) μg·L^(-1) in Child A group, significantly higher than in Child B group (44±29)μg·L^(-1), and Child C group (27±10)μg·L^(-1), p<0.01. There was no statistical difference between Child B and Child C groups. The concentration of serum IGF-I in NCT≤66s group was (78±16)μg·L^(-1), significantly higher than that in NCT>66s group (18±4)μg·L^(-1), p<0.01. CONCLUSIONS The concentration of serum IGF-I is closely related to Child-Pugh degree and NCT in patients with cirrhosis. IGF-I plays an important role in cirrhotic process and IGF-I may be related to cirrhosis complicated with SHE.