胆道闭锁患儿血清uPAR的检测及与ALT,AST,GGT水平的相关性研究
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摘要
目的探讨尿激酶纤溶酶原激活物受体(urokinase plasminogen activator receptor,uPAR)在胆道闭锁(biliary atresia,BA)患儿血清中的表达及与丙氨酸氨基转移酶(alanine aminotransferase,ALT),天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)和谷氨酰转肽酶(glutamyl transpeptidase,GGT)水平的相关性。方法随机选择2015年1月～2018年3月期间在淮安市妇幼保健院就诊的BA患儿(BA组)25例,另选择同期健康体检儿童25例作为对照组。采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)动态检测两组受试者血清uPAR水平;用全自动生化分析仪检测两组受试者血清ALT,AST和GGT水平,并进行统计学分析。结果 (1)BA组和对照组血清uPAR表达水平分别为6 059.3±418.1pg/ml和4 384.4±299.7pg/ml,差异具有统计学意义(t=16.3,P<0.01),与正常对照组相比,BA组血清uPAR表达水平明显增高。(2)BA组血清GGT,AST和ALT水平分别为2 405.1±682.3U/L,160.8±19.8U/L和158.7±21.1U/L,对照组血清GGT,AST和ALT水平分别为11.9±6.2U/L,8.2±3.8U/L和10.8±2.7U/L,差异均具有统计学意义(t=24.9～30.1,均P<0.01)。(3)BA组血清uPAR表达水平与ALT,AST和GGT水平均呈正相关,相关系数分别为0.822,0.813和0.502(均P<0.01)。结论血清uPAR参与了BA的发生、发展,且与其肝功能异常高度相关,可用于BA的预测、诊断及肝功能异常的评估。
Objective To explore the expression of urokinase plasminogen activator receptor(uPAR)in the serum of biliary atresia(BA)children and its correlation with the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transpeptidase(GGT).Methods 25 BA children(BA group)admitted in Huai'an Maternal and Child Health Hospital from January 2015 to March 2018 were randomly selected,and another 25 healthy children during the same period were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to dynamically detect the serum uPAR levels of the two groups of subjects.The serum levels of ALT,AST and GGT were measured by automatic biochemical analyzer in the two groups.Results(1)The serum uPAR expression levels of BA group and the control group were 6 059.3±418.1 pg/ml and 4 384.4±299.7 pg/ml,respectively,with statistically significant difference(t=16.3,P<0.01).Compared with the normal control group,the uPAR expressionin BA group was significantly increased.(2)The serum GGT,AST and ALT levels of the BA group were 2 405.1±682.3 U/L,160.8±19.8 U/L and 158.7±21.1 U/L,and the serum GGT,AST and ALT levels of the control group were 11.9±6.2 U/L,8.2±3.8 U/L and 10.8±2.7 U/L,respectively.The differences were all statistically significant(t=24.9～30.1,all P<0.01).(3)The uPAR expression level of the children in BA group was positively correlated with ALT,AST and GGT levels,with the correlation coefficients being0.822,0.813 and 0.502(all P≤0.01).Conclusion Serum uPAR was involved in the development of biliary atresia and was highly correlated with its liver dysfunction,which can be used to predict,diagnose biliary atresia and to evaluate liver dysfunction.
Objective To explore the expression of urokinase plasminogen activator receptor(uPAR)in the serum of biliary atresia(BA)children and its correlation with the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transpeptidase(GGT).Methods 25 BA children(BA group)admitted in Huai'an Maternal and Child Health Hospital from January 2015 to March 2018 were randomly selected,and another 25 healthy children during the same period were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to dynamically detect the serum uPAR levels of the two groups of subjects.The serum levels of ALT,AST and GGT were measured by automatic biochemical analyzer in the two groups.Results(1)The serum uPAR expression levels of BA group and the control group were 6 059.3±418.1 pg/ml and 4 384.4±299.7 pg/ml,respectively,with statistically significant difference(t=16.3,P<0.01).Compared with the normal control group,the uPAR expressionin BA group was significantly increased.(2)The serum GGT,AST and ALT levels of the BA group were 2 405.1±682.3 U/L,160.8±19.8 U/L and 158.7±21.1 U/L,and the serum GGT,AST and ALT levels of the control group were 11.9±6.2 U/L,8.2±3.8 U/L and 10.8±2.7 U/L,respectively.The differences were all statistically significant(t=24.9～30.1,all P<0.01).(3)The uPAR expression level of the children in BA group was positively correlated with ALT,AST and GGT levels,with the correlation coefficients being0.822,0.813 and 0.502(all P≤0.01).Conclusion Serum uPAR was involved in the development of biliary atresia and was highly correlated with its liver dysfunction,which can be used to predict,diagnose biliary atresia and to evaluate liver dysfunction.
引文
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[9] Chounta A,Ellinas C,Tzanetakou V,et al.Serum soluble urokinase plasminogen activator receptor as a screening test for the early diagnosis of hepatocellular carcinoma[J].Liver Int,2015,35(2):601-607.
[10] Sevgi DY,Bayraktar B,Gündüz A,et al.Serum soluble urokinase-type plasminogen activator receptor and interferon-γ-induced protein 10levels correlate with significant fibrosis in chronic hepatitis B[J].Wien Klin Wochenschr,2016,128(1-2):28-33.
[11]朱武,刘玉泉,谢万华,等.多项指标联合检测对乙型肝炎后肝硬化诊断治疗中的观察分析[J].检验医学与临床,2013,10(7):819-820,823.Zhu W,Liu YQ,Xie WH,et al.Clinical research of combined detection of four indices,AST/ALT ratio,and hepatitis B DNA in diagnosis and treatment of liver cirrhosis after hepatitis[J].Laboratory Medicine and Clinic,2013,10(7):819-820,823.
[12] Khattab H,Fouad A,Hamza M,et al.Relation of ALT and AST levels to the histopathological changes in liver biopsies of patients with chronic hepatitis C genotype A[J].Arab J Gastroenterol,2015,16(2):50-53.
[13] van Beek JHDA,de Moor MHM,Geels LM,et al.The association of alcohol intake withγ-glutamyl transferase(GGT)levels:evidence for correlated genetic effects[J].Drug Alcohol Depend,2014,134:99-105.
[2] Sj¨owall C,Martinsson K,Cardell K,et al.Soluble urokinase plasminogen activator receptor levels are associated with severity of fibrosis in nonalcoholic fatty liver disease[J].Transl Res,2015,165(6):658-666.
[3] Koch A,Zimmermann HW,Gassler N,et al.Clinical relevance and cellular source of elevated soluble urokinase plasminogen activator receptor(suPAR)in acute liver failure[J].Liver Int,2014,34(9):1330-1339.
[4] Zimmermann HW,Koch A,Seidler S,et al.Circulating soluble urokinase plasminogen activator is elevated in patients with chronic liver disease,discriminates stage and aetiologyof cirrhosis and predicts prognosis[J].Liver Int,2012,32(3):500-509.
[5] Kilgore A,Mack CL.Update on investigations pertaining to the pathogenesis of biliary atresia[J].Pediatr Surg Int,2017,33(12):1233-1241.
[6] Smith HW,Marshall CJ.Regulation of cell signalling by uPAR[J].Nat Rev Mol Cell Biol,2010,11(1):23-36.
[7] Berres ML,Schlosser B,Berg T,et al.Soluble urokinase plasminogen activator receptor is associated with progressive liver fibrosis in hepatitis C infection[J].J Clin Gastroenterol,2012,46(4):334-338.
[8] Filik L.Soluble urokinase plasminogen activator receptor in chronic hepatitis due to hepatitis C virus[J].J Clin Gastroenterol,2012,46(4):346-347.
[9] Chounta A,Ellinas C,Tzanetakou V,et al.Serum soluble urokinase plasminogen activator receptor as a screening test for the early diagnosis of hepatocellular carcinoma[J].Liver Int,2015,35(2):601-607.
[10] Sevgi DY,Bayraktar B,Gündüz A,et al.Serum soluble urokinase-type plasminogen activator receptor and interferon-γ-induced protein 10levels correlate with significant fibrosis in chronic hepatitis B[J].Wien Klin Wochenschr,2016,128(1-2):28-33.
[11]朱武,刘玉泉,谢万华,等.多项指标联合检测对乙型肝炎后肝硬化诊断治疗中的观察分析[J].检验医学与临床,2013,10(7):819-820,823.Zhu W,Liu YQ,Xie WH,et al.Clinical research of combined detection of four indices,AST/ALT ratio,and hepatitis B DNA in diagnosis and treatment of liver cirrhosis after hepatitis[J].Laboratory Medicine and Clinic,2013,10(7):819-820,823.
[12] Khattab H,Fouad A,Hamza M,et al.Relation of ALT and AST levels to the histopathological changes in liver biopsies of patients with chronic hepatitis C genotype A[J].Arab J Gastroenterol,2015,16(2):50-53.
[13] van Beek JHDA,de Moor MHM,Geels LM,et al.The association of alcohol intake withγ-glutamyl transferase(GGT)levels:evidence for correlated genetic effects[J].Drug Alcohol Depend,2014,134:99-105.