Sanada Yukihiro, Mizuta Koichi, Urahashi Taizen, Ihara Yoshiyuki, Wakiya Taiichi, Okada Noriki, Yamada Naoya, Yasuda Yoshikazu, Kawarasaki Hideo
Department of Transplant Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Pediatr Surg Int. 2012 Oct;28(10):993-6. doi: 10.1007/s00383-012-3166-7. Epub 2012 Aug 19.
The pediatric end-stage liver disease (PELD) score is not a direct index that reflects the degree of hepatocellular injury. Beta-D glucan (BDG) in the portal vein blood is processed by the hepatic reticuloendothelial system. It is possible that the hepatic clearance of BDG may be used as a biological index to assess the liver function. In this study, the relationship between PELD score and hepatic clearance of BDG was made clear in order to study the efficacy of measurement of the serum BDG.
This study including 21 patients with biliary atresia (BA) who underwent liver transplantation (LT) was performed. The BDG was measured in the preoperative peripheral vein blood and the portal vein blood at the time of LT.
The portal vein blood showed a significantly high level of BDG than the peripheral vein blood (p < 0.01). There was a significant negative correlation between the PELD score and the hepatic clearance of BDG in the 10 patients who were indicated for LT due to liver failure (p < 0.01).
The serum BDG can be used as a biological index in place of liver metabolism and should be measured in BA patients as a non-invasive indicator of the degree of progression of liver failure.
儿童终末期肝病（PELD）评分并非反映肝细胞损伤程度的直接指标。门静脉血中的β-D葡聚糖（BDG）由肝网状内皮系统处理。BDG的肝脏清除率有可能作为评估肝功能的生物学指标。在本研究中，明确了PELD评分与BDG肝脏清除率之间的关系，以研究血清BDG检测的效能。
本研究纳入了21例接受肝移植（LT）的胆道闭锁（BA）患者。在术前外周静脉血及LT时的门静脉血中检测BDG。
门静脉血中的BDG水平显著高于外周静脉血（p < 0.01）。在因肝功能衰竭而接受LT的10例患者中，PELD评分与BDG的肝脏清除率之间存在显著负相关（p < 0.01）。
血清BDG可作为替代肝脏代谢的生物学指标，应在BA患者中进行检测，作为肝衰竭进展程度的非侵入性指标。
