胆道闭锁患儿血浆胰岛素样生长因子-1的变化及临床意义

目的 了解胆道闭锁(BA)患儿血浆胰岛素样生长因子-1( IGF-1)水平的变化及其临床意义.方法 选择20例BA患儿(BA组).年龄1～3个月.于确诊后取空腹静脉血2mL,采用ELISA法检测其血浆IGF-1水平.采用全自动生化分析仪进行肝功能检测,指标包括ALT、总胆红素(TB)、结合胆红素(DB)、γ-谷氨酰转移酶(y-GT)、前清蛋白(PA)及清蛋白.另选择20例健康婴儿作为健康对照组,其性别、年龄均与BA组相匹配.结果 与健康对照组比较,BA组患儿血ALT、TB、DB及y-GT水平均显著升高(P.＝0.00),分别为(160.05-50.79)U·L-1vs(46.15±9.84)U·L-1、( 260.30±128.65)μmol·L-1 vs(16.00 ±3.46) μmol·L-1、( 191.75±85.69) μmol·L-1 vs (6.63±1.84) μnol·L-、(485.95±214.79)U·L-1 vs(44.65±13.04)U·L-1;BA组IGF-1及PA水平分别为(31.96±5.37) μg· L-1和(77.35 ±14.59) mg·L-1,显著低于健康对照组[ (54.90±8.78) μg·L-1和(126.34±11.97) ng·L-1].1GF-1与ALT、TB、DB及γ-GT之间呈高度负相关(Pa＜0.01),而与PA清蛋白呈正相关(Pa＜0.01).结论 BA患儿肝细胞合成IGF-1功能下降,IGF-1水平降低是蛋白合成低下的主要原因之一,也是反映肝细胞受损的指标.检测IGF-1水平变化对判断BA患儿肝细胞功能及营养状况具有一定意义.

Change of Serum Insulin-Like Growth Factor-1 in Infants with Biliary Atresia and Its Clinical Significance

Objective To explore the changes of serum insulin-like growth factor-1(IGF-1) in infants with biliary atresia(BA) and its clinical significance. Methods A total of 60 cases of BA with ages ranged from 1-3 months were included in this study.Blood samples were drawn on the following day after diagnosis for detection of IGF-1 by ELISA.Items of hepatic function including ALT,total bilirubin(TB),direct bilirubin(DB),gamma-glutamine(γ-GT),prealbumin(PA) and albumin were detected by using automatic biochemical analyzer.Twenty healthy infants were selected as healthy control group,and their gender and age were matched with those in BA group. Results Levels of ALT,TB,DB and γ-GT in BA group were significantly higher than those in healthy control group[(160.05±50.79) U·L-1 vs(46.15±9.84) U·L-1,(260.30±128.65) μmol·L-1 vs(16.00±3.46) μmol·L-1,(191.75±85.69) μmol·L-1 vs(6.63±1.84) μmol·L-1,(485.95 ± 214.79) U·L-1 vs(44.65±13.04) U·L-1](P_a=0.00).Levels of IGF-1 and PA in BA group were(31.96±5.37) μg·L-1 and(77.35±14.59) mg·L-1,which were markedly lower than those in healthy control group[(54.90±8.78) μg·L-1 and(126.34 ± 11.97) mg·L-1,respectively].The relevance analysis showed that IGF-1 was highly negatively related with ALT,TB,DB and γ-GT(P_a<0.01),but highly positively related with PA and moderately positive with albumin(P_a<0.01). Conclusions The capacity that hepatocyte secrets IGF-1 decreased,which could be one of the main reasons of low protein synthesis and indicator of liver cell damage in BA.Detecting serum IGF-1 level is helpful in judging hepatic cell function and nutrition status in infants with BA.