de la Maza M P, Chichester C, Hirsch S, Petermann M, Iturriaga H, Bunout D
Universidad de Chile, Santiago de Chile.
Rev Med Chil. 1997 Jan;125(1):15-21.
An elevation of serologic markers of hepatic fibrogenesis has been reported in liver diseases of different etiologies. Among these, the N-terminal type III procollagen (P-III-P) and the P1 proteolytic fragment of laminin (P1 laminin) increase in alcoholic liver damage, in proportion to the progression of this condition.
To study serum levels of P-III-P and P1 laminin in asymptomatic alcoholics with and without liver damage and decompensated alcoholic cirrhotics, compared to normal controls.
Serum P-III-P and laminin levels were measured in asymptomatic alcoholics during detoxification treatment. Liver biopsies were obtained, in order to detect liver damage, which was graded with a numeric score, considering values over 6 as severe damage. Serum fibrogenesis markers were also measured in a group of decompensated alcoholic cirrhotics.
P-III-P levels were significantly higher in cirrhotic patients compared to alcoholics with or without liver damage and to normal controls. Laminin was not different between groups. P-III-P did not correlate with histologic score in asymptomatic patients.
In this study P-III-P and P1 laminin were not usefull discriminators of severe liver damage among asymptomatic alcoholics; their levels were found to rise significantly only when liver disease has become clinically evident.
在不同病因的肝脏疾病中,均有肝纤维化血清学标志物升高的报道。其中,Ⅲ型前胶原氨基端肽(P-III-P)和层粘连蛋白P1水解片段(P1层粘连蛋白)在酒精性肝损伤中升高,且与病情进展成正比。
研究有无肝损伤的无症状酗酒者及失代偿期酒精性肝硬化患者血清中P-III-P和P1层粘连蛋白水平,并与正常对照组进行比较。
在无症状酗酒者进行解毒治疗期间检测其血清P-III-P和层粘连蛋白水平。获取肝活检组织以检测肝损伤情况,根据数值评分进行分级,将评分超过6分视为严重损伤。同时也对一组失代偿期酒精性肝硬化患者的血清纤维化标志物进行了检测。
与有或无肝损伤的酗酒者及正常对照组相比,肝硬化患者的P-III-P水平显著更高。层粘连蛋白在各研究组之间无差异。在无症状患者中,P-III-P与组织学评分无相关性。
在本研究中,P-III-P和P1层粘连蛋白对于无症状酗酒者中的严重肝损伤并无鉴别作用;仅当肝脏疾病在临床上明显表现时,其水平才会显著升高。