Serum levels of YKL-40 and PIIINP as prognostic markers in patients with alcoholic liver disease
Serum levels of YKL-40 and PIIINP as prognostic markers in patients with alcoholic liver disease
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DOI：
10.1016/s0168-8278(03)00184-3
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发表时间：
2003-08-01
影响因子：
25.7
通讯作者：
Becker, U
中科院分区：
文献类型：
--
作者：
Nojgaard, C;Johansen, JS;Becker, U
背景/目的：YKL-40（生长因子）和 PIIINP（III 型前胶原的 N 末端前肽）是肝纤维化的潜在标志物。目的是评估血清YKL-40和PIIINP水平对酒精性肝病患者的预后价值。方法：对370名酒精性肝病患者进行马洛替酯试验，中位随访期为470天； 75名患者死亡； 336 名患者在入院时接受了肝活检。通过放射免疫分析（RIA）测定血清YKL-40和PIIINP水平。结果：与对照组相比，患者血清YKL-40和PIIINP升高。脂肪变性或无纤维化患者的 YKL-40 和 PIIINP 血清水平最低，而酒精性肝炎和/或肝硬化患者的血清水平最高。血清YKL-40与纤维化的存在相关，血清PIIINP也与不同程度的纤维化相关。血清 YKL-40 或 PIIINP 升高的患者比血清 YKL-40 (P < 0.0001) 或 PIIINP (P = 0.044) 血清水平正常的患者生存期更短。高度纤维化预示着较短的生存期（P = 0.004）。结论：酒精患者的血清 YKL-40 和 PIIINP 水平升高，与肝纤维化的存在相关，并可能提供预后信息。 (C) 2003 年欧洲肝脏研究协会。由 Elsevier Science B.V. 出版。保留所有权利。
Background/Aims: YKL-40 (growth factor) and PIIINP (N-terminal propeptide of Type III procollagen) are potential markers of liver fibrosis. The aim was to evaluate the prognostic value of serum YKL-40 and PIIINP levels in patients with alcoholic liver disease.Methods: Three hundred and seventy patients with alcoholic liver disease were studied in a trial of malotilate with a median follow-up period of 470 days; 75 patients died; 336 patients had a liver biopsy on entry. Serum levels of YKL-40 and PIIINP were determined by radioimmunoassay (RIA).Results: Serum YKL-40 and PIIINP were elevated in the patients compared to controls. Patients with steatosis or no fibrosis had the lowest serum levels of YKL-40 and PIIINP, whereas patients with alcoholic hepatitis and/or cirrhosis had the highest levels. Serum YKL-40 was associated with the presence of fibrosis, and serum PIIINP was also associated with the different grades of fibrosis. Patients with elevated serum YKL-40 or PIIINP had shorter survival than patients with normal serum levels of YKL-40 (P < 0.0001) or PIIINP (P = 0.044). High degree of fibrosis predicted shorter survival (P = 0.004).Conclusions: Serum levels of YKL-40 and PIIINP are elevated in alcoholic patients, related to the presence of liver fibrosis and may provide prognostic information. (C) 2003 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.