A. Turkina, M. Maevskaya, M. Zharkova, V. Ivashkin
{"title":"失代偿期肝硬化患者白蛋白结构和功能特性的变化","authors":"A. Turkina, M. Maevskaya, M. Zharkova, V. Ivashkin","doi":"10.22416/1382-4376-2023-33-1-40-50","DOIUrl":null,"url":null,"abstract":"Аim: to conduct a comparative analysis of serum albumin's structural and functional properties in decompensated cirrhotic patients by means of spin prob EPR spectroscopy.Materials and methods. The main study group included 70 patients with decompensated liver cirrhosis and ascites. The control group consisted of 12 healthy volunteers, comparable in gender and age, without liver diseases. To assess the structural and functional ability, serum albumin was analyzed by EPR spectroscopy.Results. Albumin levels within reference intervals were found in 37 patients (59.8 %). The native albumin index decrease in cirrhotic patients as the disease progressed with the lowest values in the Child – Pugh C group (p < 0.001). The binding efficiency of albumin decreased in accordance with the severity of cirrhosis with minimal albumin binding capacity in the Child – Pugh C (Me = 25.43 %; n = 30; p < 0.001). The transport activity of RTQ albumin decreased in patients with decompensated cirrhosis, the lowest transport ability was observed in the Child – Pugh C group (Me = 26.09 %). In patients with decompensated disease the detoxification potential was significantly reduced: Child – Pugh B — Me = 44.03 %; Child – Pugh C — Me =17.16 %. Despite the normal values of serum albumin in 72.5% of patients with cirrhosis B and in 26.7% in the cirrhosis C group, only 12.3% in the cirrhosis B group had normal albumin function and in cirrhosis C nо patients had normal albumin function.Conclusion. There were not only serum concentration depletion in cirrhotic patients, but also albumin physiological non-oncotic properties were violated. The severity of these changes increased with the progression of cirrhosis. Our data allow us to raise the question of the need to use the EPR test to determine indications for albumin replacement therapy in patients with cirrhosis and the presence of ascites, even at normal values of its serum concentration.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"156 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Changes in the Structural and Functional Albumin Properties in Patients with Decompensated Liver Cirrhosis\",\"authors\":\"A. Turkina, M. Maevskaya, M. Zharkova, V. Ivashkin\",\"doi\":\"10.22416/1382-4376-2023-33-1-40-50\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Аim: to conduct a comparative analysis of serum albumin's structural and functional properties in decompensated cirrhotic patients by means of spin prob EPR spectroscopy.Materials and methods. The main study group included 70 patients with decompensated liver cirrhosis and ascites. The control group consisted of 12 healthy volunteers, comparable in gender and age, without liver diseases. To assess the structural and functional ability, serum albumin was analyzed by EPR spectroscopy.Results. Albumin levels within reference intervals were found in 37 patients (59.8 %). The native albumin index decrease in cirrhotic patients as the disease progressed with the lowest values in the Child – Pugh C group (p < 0.001). The binding efficiency of albumin decreased in accordance with the severity of cirrhosis with minimal albumin binding capacity in the Child – Pugh C (Me = 25.43 %; n = 30; p < 0.001). The transport activity of RTQ albumin decreased in patients with decompensated cirrhosis, the lowest transport ability was observed in the Child – Pugh C group (Me = 26.09 %). In patients with decompensated disease the detoxification potential was significantly reduced: Child – Pugh B — Me = 44.03 %; Child – Pugh C — Me =17.16 %. Despite the normal values of serum albumin in 72.5% of patients with cirrhosis B and in 26.7% in the cirrhosis C group, only 12.3% in the cirrhosis B group had normal albumin function and in cirrhosis C nо patients had normal albumin function.Conclusion. There were not only serum concentration depletion in cirrhotic patients, but also albumin physiological non-oncotic properties were violated. The severity of these changes increased with the progression of cirrhosis. Our data allow us to raise the question of the need to use the EPR test to determine indications for albumin replacement therapy in patients with cirrhosis and the presence of ascites, even at normal values of its serum concentration.\",\"PeriodicalId\":33798,\"journal\":{\"name\":\"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii\",\"volume\":\"156 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-05-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.22416/1382-4376-2023-33-1-40-50\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22416/1382-4376-2023-33-1-40-50","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
Аim:利用自旋探针EPR光谱对失代偿期肝硬化患者血清白蛋白的结构和功能特性进行比较分析。材料和方法。主要研究组包括70例失代偿性肝硬化和腹水患者。对照组由12名健康志愿者组成,性别和年龄相当,无肝脏疾病。用EPR谱分析血清白蛋白的结构和功能。37例(59.8%)患者白蛋白水平在参考区间内。肝硬化患者的天然白蛋白指数随着疾病的进展而下降,Child - Pugh C组最低(p < 0.001)。白蛋白结合效率随肝硬化严重程度降低,Child - Pugh C中白蛋白结合能力最低(Me = 25.43%;N = 30;P < 0.001)。失代偿性肝硬化患者RTQ白蛋白转运活性降低,Child - Pugh C组转运能力最低(Me = 26.09%)。失代偿性疾病患者的解毒潜能明显降低:Child - Pugh B - Me = 44.03%;儿童- Pugh C - Me = 17.16%。72.5%的B型肝硬化患者血清白蛋白正常,26.7%的C型肝硬化患者血清白蛋白正常,但B型肝硬化患者血清白蛋白功能仅12.3%正常,C型肝硬化患者血清白蛋白功能正常。肝硬化患者不仅血清浓度降低,而且白蛋白生理非肿瘤特性也被破坏。这些变化的严重程度随着肝硬化的进展而增加。我们的数据使我们提出了一个问题,即需要使用EPR试验来确定肝硬化和腹水患者白蛋白替代治疗的适应症,即使在其血清浓度正常的情况下。
Changes in the Structural and Functional Albumin Properties in Patients with Decompensated Liver Cirrhosis
Аim: to conduct a comparative analysis of serum albumin's structural and functional properties in decompensated cirrhotic patients by means of spin prob EPR spectroscopy.Materials and methods. The main study group included 70 patients with decompensated liver cirrhosis and ascites. The control group consisted of 12 healthy volunteers, comparable in gender and age, without liver diseases. To assess the structural and functional ability, serum albumin was analyzed by EPR spectroscopy.Results. Albumin levels within reference intervals were found in 37 patients (59.8 %). The native albumin index decrease in cirrhotic patients as the disease progressed with the lowest values in the Child – Pugh C group (p < 0.001). The binding efficiency of albumin decreased in accordance with the severity of cirrhosis with minimal albumin binding capacity in the Child – Pugh C (Me = 25.43 %; n = 30; p < 0.001). The transport activity of RTQ albumin decreased in patients with decompensated cirrhosis, the lowest transport ability was observed in the Child – Pugh C group (Me = 26.09 %). In patients with decompensated disease the detoxification potential was significantly reduced: Child – Pugh B — Me = 44.03 %; Child – Pugh C — Me =17.16 %. Despite the normal values of serum albumin in 72.5% of patients with cirrhosis B and in 26.7% in the cirrhosis C group, only 12.3% in the cirrhosis B group had normal albumin function and in cirrhosis C nо patients had normal albumin function.Conclusion. There were not only serum concentration depletion in cirrhotic patients, but also albumin physiological non-oncotic properties were violated. The severity of these changes increased with the progression of cirrhosis. Our data allow us to raise the question of the need to use the EPR test to determine indications for albumin replacement therapy in patients with cirrhosis and the presence of ascites, even at normal values of its serum concentration.