诱饵受体 3 在慢加急性肝衰竭中的表达及临床意义。
Expression and Clinical Significance of Decoy Receptor 3 in Acute-on-Chronic Liver Failure.
机构信息
Liver Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China.
Fujian Key Lab of Individualized Active Immunotherapy and Key Lab of Radiation Biology of Fujian Province Universities, Fuzhou 350005, China.
出版信息
Biomed Res Int. 2019 Jun 18;2019:9145736. doi: 10.1155/2019/9145736. eCollection 2019.
AIMS
To explore the expression level and clinical significance of decoy receptor 3 (DcR3) in patients with acute-on-chronic liver failure (ACLF).
METHODS
Serum DcR3 levels were measured by enzyme-linked immunosorbent assay (ELISA) in 76 patients with ACLF and 41 non-ACLF patients with chronic liver disease. Blood routine and liver functions were accessed for their correlations with DcR3.
RESULTS
Serum DcR3 in ACLF patients was significantly higher than that in non-ACLF patients. It was positively correlated with neutrophilic granulocyte, aspartate aminotransferase, prothrombin time, and international standardized ratio, but negatively correlated with platelet and serum albumin. At the early stage, the level of DcR3 was not significantly different between the survival and nonsurvival group of ACLF. However, at the late stage, DcR3 increased in nonsurvival and gradually decreased in survivals. The baseline DcR3 could not sufficiently predict the outcome of ACLF, while the change of DcR3 within the first week displayed a better predictive value than model for end-stage liver disease (MELD) score.
CONCLUSIONS
DcR3 was highly expressed in patients with ACLF and correlated with several clinical indices. Dynamic change of DcR3 might predict the prognosis of ACLF.
目的
探讨凋亡信号调节激酶 3 （DcR3）在慢性肝衰竭急性发作（ACLF）患者中的表达水平及临床意义。
方法
采用酶联免疫吸附试验（ELISA）检测 76 例 ACLF 患者和 41 例非 ACLF 慢性肝病患者血清 DcR3 水平，并分析其与血常规和肝功能指标的相关性。
结果
ACLF 患者血清 DcR3 水平明显高于非 ACLF 患者，与中性粒细胞计数、天冬氨酸转氨酶、凝血酶原时间和国际标准化比值呈正相关，与血小板计数和血清白蛋白呈负相关。在 ACLF 早期，存活组和死亡组患者血清 DcR3 水平无明显差异，但在晚期，死亡组患者 DcR3 逐渐升高，而存活组患者 DcR3 逐渐降低。基线 DcR3 水平不能充分预测 ACLF 的结局，而第 1 周内 DcR3 的变化比终末期肝病模型（MELD）评分具有更好的预测价值。
结论
DcR3 在 ACLF 患者中高表达，并与多项临床指标相关。DcR3 的动态变化可能有助于预测 ACLF 的预后。
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