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目的 探讨阻塞性黄疸患者生长激素 /胰岛素样生长因子 Ⅰ轴的变化及其临床意义。方法 对 6 0例男性阻塞性黄疸患者 (阻黄组 )围手术期血浆生长激素、生长激素结合蛋白、胰岛素样生长因子 ,内毒素、肝功能及前白蛋白水平进行观察 ,并与 40例男性单纯性胆囊结石患者 (对照组 )进行比较。结果 生长激素、生长激素结合蛋白、胰岛素样生长因子 Ⅰ在阻黄组分别为 7.4μg/L± 3.6μg/L、9.1± 2 .3B/T 10 0、49.8mg/L± 6 .6mg/L ,较对照组 (13.9μg/L± 5 .7μg/L、13.3± 1.6B/T 10 0、6 1.4mg/L± 6 .5mg/L显著降低 ,差异有显著意义 (P <0 .0 1) ,并与黄疸程度 ,前白蛋白、内毒素水平相关 (P <0 .0 1)。结论 阻塞性黄疸患者生长激素 /胰岛素样生长因子 Ⅰ轴存在明显下调。其原因可能与营养障碍、内毒素血症引起的生长激素受体表达受抑有关 ,并可进一步加重营养障碍和内毒素血症 ,是介导阻塞性黄疸病理生理改变的重要因素
Objective To investigate the changes of growth hormone / insulin-like growth factor-Ⅰ axis in patients with obstructive jaundice and its clinical significance. Methods The levels of plasma growth hormone, growth hormone binding protein, insulin-like growth factor, endotoxin, liver function and prealbumin in 60 patients with obstructive jaundice (yellow block) during perioperative period were observed and compared with 40 male Patients with simple gallstones (control group) were compared. Results Growth hormone, growth hormone binding protein and insulin - like growth factor Ⅰ were significantly increased in the yellowing group as 7.4μg / L ± 3.6μg / L, 9.1 ± 2.3B / T 10 0, 49.8mg / L ± 6. 6mg / L , Which was significantly lower than that of the control group (13.9μg / L ± 5.7μg / L, 13.3 ± 1.6B / T 10 0,6.4mg / L ± 6.5mg / L, P <0.01 ), And related to the degree of jaundice, prealbumin and endotoxin (P <0.01) .Conclusion There is a significant downregulation of growth hormone / insulin-like growth factor I axis in patients with obstructive jaundice, which may be related to nutritional disorders, Toxemia-induced growth hormone receptor expression suppression, and can further aggravate nutritional disorders and endotoxemia, is an important factor in the pathophysiology of obstructive jaundice