关键词: 酒精性肝硬化, 过氧化脂质, 脂联素, 转化生长因子-β1, 病情程度, 预后

Abstract: Objective To investigate the value of a combined determination with lipid peroxide (LPO), adiponectin (APN) and transforming growth factor -β1 (TGF-β1) for the severity and prognosis of alcoholic cirrhosis (ALC). Methods One hundred and fifty-two patients with alcoholic liver disease (ALD) were divided into alcoholic fatty liver (AFL) group, alcoholic hepatitis (AH) group and ALC group according to the types of their diseases. The ALC group was further divided into A, B and C subgroups according to the modified Child-Pugh grading standard, and mild, moderate and severe subgroups according to the model of end-stage liver disease (MELD) scoring standard. The levels of serum LPO, APN and TGF-β1 in patients of AFL, AH and ALC groups, and in different subgroups of patients in the ALC group were compared. The correlation between the levels of LPO, APN and TGF-β1 and total bilirubin (TBil), Albumin (Alb) and liver hardness (LSM) in ALC group were analyzed by Pearson method. Receiver operating characteristic (ROC) curves were drawn and the diagnostic efficacies of LPO, APN and TGF-β1 for the severity and prognosis of ALC patients were analyzed. Results The levels of LPO and TGF-β1 in ALC group were 7.56±1.68 μmol/L and 287.63±59.52 μg/L, respectively, which were higher than those of AH group (4.92±1.03 μmol/L and 3.46±0.85 μmol/L) and AFL group (215.19±43.87 μg/L and 168.53±32.48 μg/L); APN level was 4.29±1.03 mg/L, which was lower than those of 7.46±1.82 mg/L in AH group and 12.57±3.46 mg/L in AFL group (F=16.736, 13.275, 19.418, P<0.05). The levels of LPO and TGF-β1 in child-Pugh grade C subgroup of ALC group were 9.04±1.85μmol/L and 341.67±70.25μg/L . respectively, which were higher than those of 7.38±1.52μmol/L, 6.13±1.27 μmol/L in grade B, and 279.83±57.46 μg/L, 234.51±48.38 μg/L in grade A subgroups. The APN level in child-Pugh grade C subgroup was 3.37±0.85 mg/L, which was lower than those of 4.42±1.16 mg/L in grade B and 5.76±1.34 mg/L in grade A subgroups (F=13.259, 11.762, 15.386, P<0.05). The levels of LPO and TGF-β1 in the severe subgroup of ALC group were 9.83±1.96 μmol/L and 364.78±76.91 μg/L, respectively, which were higher than those of moderate (7.54±1.61 μmol/L and 5.83±1.14 μmol/L) and mild (290.62±59.73 μg/L and 225.76±45.82 μg/L) subgroups. APN level was 3.08±0.74 mg/L, which was lower than those of moderate (4.26±1.09 mg/L) and mild (5.93±1.42 mg/L) subgroups (F=15.461, 13.628, 17.853, P<0.05). Pearson analysis showed that LPO and TGF-β1 levels of ALC were positively correlated with TBil and LSM levels, but negatively correlated with Alb levels. APN level was positively correlated with Alb level, but negatively correlated with TBil and LSM level (P<0.05). ROC curve analysis showed that the AUC of LPO, APN and TGF-β1 and their combined efficacies on the diagnosis of ALC were 0.806, 0.784, 0.835 and 0.928, respectively, and the combined evaluation efficacy was higher than any individual detection (P<0.05).Conclusion The levels of LPO, APN and TGF-β1 are of high value in evaluating the severity and prognosis of ALC patients, and their combined evaluation is most effective.

Key words: Alcoholic cirrhosis, Lipid peroxide, Adiponectin, Transforming growth factor -β1, Degree of illness, Prognosis