原发性胆汁性肝硬化患者血浆可溶型肿瘤坏死因子相关凋亡诱导配体的表达及临床意义
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国家高技术研究发展计划(“863”计划)(2006AA022496);国家自然科学基金(30471616);上海市科委重大科技攻关基金(04DZ19116).


Plasma level of soluble tumor necrosis factor-related apoptosis-inducing ligand in patients with primary biliary cirrhosis: expression and clinical significance
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    目的:检测原发性胆汁性肝硬化(PBC)患者血浆可溶型肿瘤坏死因子相关凋亡诱导配体(sTRAIL)水平并探讨其临床意义。方法:采用ELISA法检测30例PBC、25例慢性肝炎肝硬化及30例正常对照者血浆sTRAIL水平,同时检测血浆r谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)浓度,分析sTRAIL与GGT、ALP的相关性。赔呆:PBC患者血浆sTRAIL水平为(1543.9±344.2)pg/ml,显著高于正常对照组[(1098.5±264.7)pg/ml,P〈0.01];肝炎肝硬化患者血浆sTRAIL水平为(1624.1±415.8)pg/ml,也较正常对照组明显升高(P〈0.05)。PBC患者血浆sTRAIL水平与GGT、ALP呈正相关(r=0.63,0.71,P〈0.01);肝炎肝硬化患者血浆sTRAIL与GGT、ALP均不相关(r=0.43、0.31,P〉0.05)。结论:PBC患者血浆sTRAIL水平升高,且与GGT、ALP呈正相关,提示sTRAIL可能参与PBC患者肝内胆管损伤,且与疾病活动度相关。

    Abstract:

    Objective:To determine the plasma level of soluble tumor necrosis factor-related apoptosis-inducing ligand (sTRAIL) in patients with primary biliary cirrhosis (PBC) and to explore its clinical significance. Methods: The plasma levels of sTRAIL were examined in 30 patients with PBC, 25 patients with chronic hepatitis and cirrhosis, and 30 healthy donors with ELISA. Meanwhile, the concentrations of plasma gamma-glutamyltransferase (GGT) and alkaline phosphatase (ALP) were examined and their correlation with sTRAIL was analyzed. Results: The plasma level of sTRAIL in PBC patients was (1 543.9±344.2) pg/ml ,which was significantly higher than that of healthy donors ([1 098.5 ± 264.7] pg/ml, P〈0.01) ; sTRAIL level in patients with chronic hepatitis and cirrhosis was (1 624.1±415.8) pg/ml, which was significantly higher than that of control ([1 098.5±264.7] pg/ml, P〈0.05). We also found that sTRAIL level was positively correlated with GGT and ALP concentrations in PBC patients (r=0. 63,0. 71, P〈0.01), but not with those in patients with chronic hepatitis and cirrhosis (r=0. 43,0.31 ,P〈0.05). Conclusion: Plasma sTRAIL level is elevated in PBC patients and is correlated with GGT and ALP concentrations, indicating that sTRAIL may contribute to the impair of the intrahepatic bile ducts and is associated with the mobility of PBC.

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