胆道闭锁患儿血清GPC3、TGF-β1和VEGF水平与肝硬度值和肝功能的关系研究

Study on the Relationship between Serum GPC3, TGF-β1, VEGF Levels and Liver Stiffness, Liver Function in Children with Biliary Atresia

目的:研究胆道闭锁(BA)患儿血清磷脂酰肌醇蛋白聚糖3(GPC3)、转化生子因子β1(TGF-β1)和血管内皮生长因子(VEGF)水平与肝硬度值和肝功能的关系。方法:选择2016月3月-2019年3月期间在我院接受Kasai手术治疗的62例BA患儿作为研究对象(BA组),并根据总胆红素水平分为黄疸患儿(总胆红素≥34.2μmol/L)、无黄疸患儿(总胆红素<34.2μmol/L);另取同期在本院体检的50例健康儿童作为对照组。检测BA组患儿术后2个月、对照组儿童体检时的血清GPC3、TGF-β1、VEGF及肝功能指标白蛋白(ALB)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(GGT)的水平及肝硬度值,采用Pearson相关分析血清GPC3、TGF-β1和VEGF水平与肝硬度值和肝功能的相关性。结果:BA组患儿的血清GPC3、TGF-β1、VEGF、ALT、AST、GGT水平及肝硬度值均明显高于对照组(P<0.05),血清ALB水平与对照组比较无统计学差异(P>0.05);BA组中黄疸患儿的血清GPC3、TGF-β1、VEGF、ALT、AST、GGT水平及肝硬度值均明显高于无黄疸患儿,血清ALB水平明显低于无黄疸患儿(P<0.05);BA组中血清GPC3、TGF-β1、VEGF水平与血清ALT、AST、GGT水平及肝硬度值呈正相关(P<0.05),与血清ALB水平呈负相关(P<0.05)。结论:BA患儿术后GPC3、TGF-β1和VEGF的升高与肝纤维化进程、肝功能破坏有关,未来可能成为研究BA术后肝纤维化发生机制的靶点。

Objective: To study the relationship between serum glypican-3(GPC3), transforming growth factor-β1(TGF-β1) and vascular endothelial growth factor(VEGF) levels and liver hardness, liver function in children with biliary atresia(BA). Methods: 62 children with BA who underwent Kasai operation in our hospital from March 2016 to March 2019 were selected as research objects(BA group), and they were divided into jaundiced children(total bilirubin ≥34.2 μmol/L) and non-jaundiced children(total bilirubin<34.2 μmol/L) according to the level of total bilirubin. Another 50 healthy children who underwent physical examination in our hospital during the same period were selected as control group. Serum levels of GPC3, TGF-β1, VEGF and liver function indicators including albumin(ALB), alanine aminotransferase(ALT), aspartate aminotransferase(AST), gamma-glutamyl transpeptidase(GGT)and liver hardness were measured in BA group 2 months after operation and in control group during physical examination. Pearson correlation analysis was used to analyze the correlation between serum GPC3, TGF-β1 and VEGF levels and liver hardness and liver function. Results: The levels of serum GPC3, TGF-β1, VEGF, ALT, AST, GGT and liver hardness in BA group were significantly higher than those in control group(P<0.05), and there was no difference between the two groups of ALB level(P>0.05). The levels of serum GPC3, TGF-β1, VEGF, ALT, AST, GGT and liver hardness of jaundice children in BA group were significantly higher than those of non-jaundice children, and the levels of serum ALB were significantly lower than those in non-jaundice children(P<0.05). The serum levels of GPC3, TGF-β1 and VEGF in BA group positively correlated with serum ALT, AST, GGT and liver hardness(P<0.05),negatively correlated with serum ALB(P<0.05). Conclusion: The increase of GPC3, TGF-β1 and VEGF after operation in children with BA is related to the progression of liver fibrosis and the damage of liver function. In the future, it may be a target to study the mechanism of liver fibrosis after BA operation.