Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Klinikum der Goethe-Universität, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany.
J Hepatol. 2013 May;58(5):956-61. doi: 10.1016/j.jhep.2013.01.005. Epub 2013 Jan 16.
BACKGROUND & AIMS: Soluble CD163 (sCD163) is shed in the blood circulation by activated macrophages, correlates strongly with the hepatic venous pressure gradient (HVPG) and is thereby a good indicator of portal hypertension. It is unknown whether sCD163 correlates with the risk of variceal bleeding and overall survival (OS) in patients with liver cirrhosis. We performed a prospective study to investigate if sCD163 serum levels correlate with the risk of variceal bleeding and OS in cirrhotic patients.
Patients with liver cirrhosis were prospectively enrolled and followed until death or last contact. At the day of inclusion in the study, blood samples were taken and sCD163 serum levels were assessed by ELISA (enzyme-linked immunosorbent assay). The time until the end points death and variceal bleeding was assessed and the risks of death or variceal bleeding were calculated with uni- and multivariate Cox regression analyses.
High sCD163 levels (>4100 ng/L) were associated with death independently of the MELD (model of end stage liver disease) score, CRP (C-reactive protein), age and gender. Furthermore, high sCD163 levels were associated with gastrointestinal bleeding independently of the variceal stage and red spots.
The sCD163 serum level is a new independent non-invasive risk factor for death and variceal bleeding in cirrhotic patients.
可溶性 CD163（sCD163）由活化的巨噬细胞在血液循环中释放，与肝静脉压力梯度（HVPG）密切相关，是门脉高压的良好指标。目前尚不清楚 sCD163 是否与肝硬化患者的静脉曲张出血风险和总生存（OS）相关。我们进行了一项前瞻性研究，以调查 sCD163 血清水平是否与肝硬化患者的静脉曲张出血风险和 OS 相关。
前瞻性招募肝硬化患者并进行随访，直至死亡或最后一次联系。在纳入研究的当天，采集血样并通过 ELISA（酶联免疫吸附试验）检测 sCD163 血清水平。评估到达终点（死亡和静脉曲张出血）的时间，并使用单变量和多变量 Cox 回归分析计算死亡或静脉曲张出血的风险。
高 sCD163 水平（>4100ng/L）与死亡独立相关，与 MELD（终末期肝病模型）评分、CRP（C 反应蛋白）、年龄和性别无关。此外，高 sCD163 水平与胃肠道出血独立相关，与静脉曲张分期和红点无关。
sCD163 血清水平是肝硬化患者死亡和静脉曲张出血的新的独立非侵入性危险因素。
