HEMODYNAMIC AND LIVER-FUNCTION PREDICTORS OF SERUM HYALURONAN IN ALCOHOLIC LIVER-DISEASE
HEMODYNAMIC AND LIVER-FUNCTION PREDICTORS OF SERUM HYALURONAN IN ALCOHOLIC LIVER-DISEASE
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DOI：
10.1002/hep.1840150614
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发表时间：
1992-06-01
期刊：
影响因子：
13.5
通讯作者：
DUDLEY, FJ
中科院分区：
文献类型：
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作者：
GIBSON, PR;FRASER, JRE;DUDLEY, FJ
为了确定慢性肝病患者血清透明质酸的肝脏预测因子，对62例酒精性肝病患者进行了评价。第1组30例患者同时进行血清透明质酸、肝功能检查、Pugh分级和血流动力学指标评估。第二个重叠组42例患者（第2组）也测量了安替比林清除率，但没有进行血流动力学评估。除6例患者外，所有患者血清透明质酸水平均升高。在两组中，血清透明质酸水平在Pugh分级之间存在差异，并且在每组中，与Pugh A级相比，Pugh C级的血清透明质酸水平显著更高（p < 0.05，Kruskal-Wallis检验）。相关性分析显示，血清透明质酸与第1组中的几个指标显著相关，但在多元线性回归中，仅确定了血清透明质酸的三个统计学独立预测因子：血清白蛋白（p = 0.008）、吲哚菁绿色清除率（p = 0.024）和吲哚菁绿色提取率（p = 0.036）。这些相关性的总体R2为65%。在第二组中，安替比林清除率与血清透明质酸无显著相关性（r = 0.29，p = 0.06），但其他相关性与第一组相似。在多变量分析中，只有血清白蛋白预测血清透明质酸（p < 0.001; R2 = 43%）。总之，肝细胞合成功能，肝窦血流和肝内分流程度的指数是酒精性肝病血清透明质酸的独立预测因子。这些数据表明血清透明质酸的独特性质，并建议其潜在的应用评估急性血液动力学变化的肝病患者。
To define hepatic predictors of serum hyaluronan in patients with chronic liver disease, 62 patients with alcoholic liver disease were evaluated. In group 1, 30 patients had concurrent assessment of serum hyaluronan, liver function tests, Pugh grade and hemodynamic indices. A second, overlapping group of 42 patients (group 2) also had antipyrine clearance measured but without hemodynamic assessment. All but six patients had elevated serum hyaluronan levels. In both groups, serum hyaluronan levels differed between Pugh grades and, in each group, was significantly greater in Pugh grade C compared with those in Pugh grade A (p < 0.05, Kruskal-Wallis test). When analyzed by correlation, serum hyaluronan was significantly associated with several indices in group 1, but on multivariate linear regression only three statistically independent predictors of serum hyaluronan were identified: serum albumin (p = 0.008), indocyanine green clearance (p = 0.024) and indocyanine green extraction (p = 0.036). The overall R2 for these correlates was 65%. In the second group, antipyrine clearance was not significantly associated with serum hyaluronan (r = 0.29, p = 0.06), but other associations were similar to the first group. On multivariate analysis, only serum albumin predicted serum hyaluronan (p < 0.001; R2 = 43%). In conclusion, indices of hepatocyte synthetic function, sinusoidal blood flow and degree of intrahepatic shunting are independent predictors of serum hyaluronan in alcoholic liver disease. These data show the unique nature of serum hyaluronan and suggest its potential application to the assessment of acute hemodynamic changes in patients with liver disease.