Fouad Rabab, Hamza Iman, Khairy Marwa, Elsharkawy Marwa, Helmy Amal A
1 Hepatology Unit, Endemic Medicine Department, Cairo University , Cairo, Egypt .
2 Clinical Pathology Department, Faculty of Medicine, Cairo University , Cairo, Egypt .
J Interferon Cytokine Res. 2017 Mar;37(3):112-118. doi: 10.1089/jir.2016.0098.
Research is continuous for noninvasive tools for the prediction of portal hypertension than upper gastrointestinal endoscopy. Serum sCD163 correlates with hepatic venous pressure gradient, aiding in the prediction of portal hypertension. We aimed at investigating the role of sCD163 in the prediction of the presence and size of varices as well as a stratification tool for surveillance or prophylaxis by assessment of prognosis and risk of bleeding. Two hundred forty-three cirrhotic patients were divided into 3 groups: group I: no varices, group II: small-sized varices, and group III: medium-sized and large-sized varices. Serum sCD163 levels were assessed and correlated with abdominal ultrasound and laboratory investigations. Follow-up for 1 year was conducted to assess the risk of bleeding, and band ligation was performed for significant varices with follow-up of obliteration. sCD163 levels were significantly higher in patients with varices requiring prophylactic interventions (P = 0.03) and in large varices (P = 0.012), patients at risk of bleeding (P = 0.04), and the bleeder patients (P = 0.001). No relationship between the sCD163 levels and the rate of variceal obliteration was reported. sCD163 levels were positively correlated with the Child score (P = 0.05), the portal vein diameter (P = 0.02), and the splenic size (P = 0.04). Although sCD163 level cannot predict the development of varices, it serves as a good predictor for the detection of size of varices (large varices), the need of prophylactic interventions, and risk of variceal bleeding. sCD163 level is a helpful indicator with the progression of cirrhosis and portal hypertension.
对于门静脉高压的预测，无创工具的研究一直在持续，且优于上消化道内镜检查。血清可溶性细胞间黏附分子-163（sCD163）与肝静脉压力梯度相关，有助于预测门静脉高压。我们旨在通过评估预后和出血风险，研究sCD163在预测静脉曲张的存在和大小以及作为监测或预防分层工具中的作用。243例肝硬化患者被分为3组：I组：无静脉曲张；II组：小静脉曲张；III组：中、大静脉曲张。评估血清sCD163水平，并与腹部超声和实验室检查结果进行相关性分析。进行1年的随访以评估出血风险，对有明显静脉曲张的患者进行套扎，并随访静脉曲张闭塞情况。需要预防性干预的静脉曲张患者（P = 0.03）、大静脉曲张患者（P = 0.012）、有出血风险的患者（P = 0.04）和出血患者（P = 0.001）的sCD163水平显著更高。未报告sCD163水平与静脉曲张闭塞率之间的关系。sCD163水平与Child评分（P = 0.05）、门静脉直径（P = 0.02）和脾脏大小（P = 0.04）呈正相关。虽然sCD163水平不能预测静脉曲张的发生，但它是检测静脉曲张大小（大静脉曲张）、预防性干预需求和静脉曲张出血风险的良好预测指标。sCD163水平是肝硬化和门静脉高压进展的一个有用指标。
