Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil Núcleo de Estudos em Gastroenterologia e Hepatologia, Department of Internal Medicine.
University Hospital Polydoro Ernani de São Thiago - Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil Postgraduate Program in Medical Sciences.
Ann Hepatol. 2017 Sep-Oct;16(5):780-787. doi: 10.5604/01.3001.0010.2789.
Despite the circulating levels of PTX3 were related to the severity of various diseases, there are no studies investigating its role in patients with liver cirrhosis. We aimed to study PTX3 levels in patients with liver cirrhosis.
A prospective cohort study included 130 patients hospitalized for acute decompensation of liver cirrhosis, 29 stable cirrhotic outpatients and 32 healthy controls evaluated in a tertiary hospital in Southern Brasil.
The median PTX3 level was significantly higher in stable cirrhotic patients compared to controls (2.6 vs. 1.1 ng/mL; p < 0.001), hospitalized cirrhotic patients compared to controls (3.8 vs. 1.1 ng/mL; p < 0.001), and hospitalized cirrhotic patients compared to stable cirrhotic patients (3.8 vs. 2.6 ng/mL; p = 0.001). A positive correlation was found between PTX3 and serum creatinine (r = 0.220; p = 0.012), Chronic Liver Failure - Sequential Organ Failure Assessment score (CLIF-SOFA) (r = 0.220; p = 0.010), MELD (r = 0.279; p = 0.001) and Child-Pugh score (r = 0.224; p = 0.010). Significantly higher levels of PTX3 were observed in patients on admission with ACLF (8.9 vs. 3.1 ng/mL; p < 0.001) and MELD score ≥ 20 (6.6 vs. 3.4 ng/mL; p = 0.002). Death within 90 days occurred in 30.8% of patients and was associated with higher levels of PTX3 (5.3 vs. 3.4 ng/mL; p = 0.009). The probability of Kaplan-Meier survival was 77.0% in patients with PTX-3 < 5.3 ng mL (upper tercile) and 53.5% in those with PTX3 ≥ 5.3 ng/mL (p = 0.002).
These results indicate the potential for use of PTX3 as an inflammatory biomarker for the prognosis of patients with hepatic cirrhosis.
尽管血浆 PX3 水平与各种疾病的严重程度有关，但目前尚无研究探讨其在肝硬化患者中的作用。我们旨在研究肝硬化患者的 PX3 水平。
一项前瞻性队列研究纳入了 130 名因肝硬化急性失代偿而住院的患者、29 名稳定期肝硬化门诊患者和 32 名健康对照者，均在巴西南部的一家三级医院进行评估。
稳定期肝硬化患者的 PX3 水平明显高于对照组（2.6 与 1.1 ng/ml；p < 0.001）、住院肝硬化患者高于对照组（3.8 与 1.1 ng/ml；p < 0.001），住院肝硬化患者也高于稳定期肝硬化患者（3.8 与 2.6 ng/ml；p = 0.001）。PTX3 与血清肌酐（r = 0.220；p = 0.012）、慢性肝脏衰竭-序贯器官衰竭评估评分（CLIF-SOFA）（r = 0.220；p = 0.010）、MELD 评分（r = 0.279；p = 0.001）和 Child-Pugh 评分（r = 0.224；p = 0.010）呈正相关。在入院时患有 ACLF（8.9 与 3.1 ng/ml；p < 0.001）和 MELD 评分≥20（6.6 与 3.4 ng/ml；p = 0.002）的患者中，PTX3 水平显著升高。90 天内死亡的患者有 30.8%，与较高的 PTX3 水平（5.3 与 3.4 ng/ml；p = 0.009）相关。PTX-3<5.3ng/mL（上四分位数）的患者的 Kaplan-Meier 生存概率为 77.0%，而 PTX3≥5.3ng/mL 的患者为 53.5%（p = 0.002）。
这些结果表明，PTX3 有可能作为肝硬化患者预后的炎症生物标志物。
