病毒性肝炎患者血清中游离胰岛素样生长因子1检测

目的检测慢性病毒性肝炎、肝硬化和慢性重型肝炎患者血清中的游离胰岛素样生长因子1(IGF-1)水平变化,分析IGF-1与患者的病情和预后关系.方法应用酶联免疫吸附法(ELISA)检测43例慢性肝炎、20例肝硬化和12例慢性重型肝炎患者血清游离IGF-1水平,并与肝功能指标进行对照.结果慢性重型肝炎、肝硬化和慢性肝炎患者血清游离IGF-1水平分别为(0.23±0.18)ng/ml、(0.37±0.24)ng/ml和(1.15±0.72)ng/ml,慢性重型肝炎、肝硬化患者明显较慢性肝炎低.5例血清游离IGF-1<0.2ng/ml的慢性重型肝炎患者均死亡,4例>0.3ng/ml者存活,3例在0.2～0.3ng/ml之间,其中2例死亡,1例好转.白蛋白在30g/L以下患者的血清游离IGF-1浓度显著低于白蛋白在31g/L以上的患者.结论血清游离IGF-1水平与病情程度、白蛋白合成有密切相关,并可作为判断慢性重型肝炎预后的一个重要指标.

Detection of serum free insulin like growth factor 1 in patients with chronic viral hepatitis

Objective To evaluate the serum free insulin like growth factor 1(IGF 1) level and its relation with the severity and prognosis in patients with chronic viral hepatitis,liver cirrhosis and severe chronic hepatitis. Methods Serum free IGF 1 was detected by ELISA in 43 patients with chronic viral hepatitis,20 with liver cirrhosis and 12 with chronic severe hepatitis. Results Serum free IGF 1 was significantly decreased in patients with liver cirrhosis and severe chronic hepatitis.Five patients with chronic severe hepatitis whose serum free IGF 1 was lower than 0.2 ng/l died during follow up.Four patients whose serum free IGF 1 above 0.3 ng/l survived.Serum free IGF 1 was significantly reduced in patients with albumin lower than 30 g/l.Conclusion Serum free IGF 1 is decreased in patients with liver cirrhosis and severe chronic hepatitis and it can predict the prognosis of patients with severe chronic hepatitis.