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目的:探讨肝硬化患者血浆纤溶酶原激活物抑制剂1(PAI-1)的变化及其意义。方法:共收集血吸虫肝硬化患者20例,乙型肝炎后肝硬化患者45例,丙型肝炎后肝硬化患者15例,行Child-pugh分级:A级27例(A组),B级31例(B组),C级22例(C组)。10例体检健康者为正常对照组。酶联免疫吸附实验检测Ⅰ、Ⅲ型胶原和血浆PAI-1的变化。结果:血吸虫肝硬化患者、乙型肝炎后肝硬化患者、丙型肝炎后肝硬化患者血浆中PAI-1和Ⅰ、Ⅲ型胶原表达无统计学差异。但随肝硬化进展,血浆PAI-1和Ⅰ、Ⅲ型胶原表达逐渐增加,C组患者血浆PAI-1水平为(51.48±2.83)μg/L,B组为(40.39±2.64)μg/L,A组为(25.67±1.43)μg/L,各组间差异均有统计学意义(P<0.01)。结论:PAI-1在肝硬化进展中持续上调,可能参与胶原的表达调控,血浆PAI-1和Ⅰ、Ⅲ型胶原与肝硬化发展密切相关。
Objective: To investigate the changes and clinical significance of plasma plasminogen activator inhibitor 1 (PAI-1) in cirrhotic patients. Methods: A total of 20 patients with cirrhosis of schistosomiasis, 45 patients with post-hepatitis B cirrhosis and 15 patients with post-hepatitis C cirrhosis were enrolled. Child-pugh grading was performed in 27 patients (group A), 31 patients in grade B (Group B) and 22 cases of class C (group C). 10 cases of healthy people as the normal control group. The changes of type I, type Ⅲ collagen and plasma PAI-1 were detected by enzyme linked immunosorbent assay. Results: There was no significant difference in the expression of PAI-1 and type I and type III collagen in patients with cirrhosis, hepatitis B and cirrhosis after hepatitis C infection. However, with the progress of liver cirrhosis, the expression of PAI-1 and type I and type III collagen gradually increased, the level of PAI-1 in group C was (51.48 ± 2.83) μg / L and that in group B was (40.39 ± 2.64) μg / L, A group was (25.67 ± 1.43) μg / L, the differences between the groups were statistically significant (P <0.01). CONCLUSION: PAI-1 is continuously up-regulated in the progression of liver cirrhosis and may be involved in the regulation of collagen expression. PAI-1 and type I and III collagen are closely related to the development of liver cirrhosis.