目的　检测慢性病毒性肝炎、肝硬化和慢性重型肝炎患者血清中的游离胰岛素样生长因子 1(IGF 1)水平变化 ,分析IGF 1与患者的病情和预后关系。方法　应用酶联免疫吸附法 (ELISA)检测 43例慢性肝炎、2 0例肝硬化和 12例慢性重型肝炎患者血清游离IGF 1水平 ,并与肝功能指标进行对照。结果　慢性重型肝炎、肝硬化和慢性肝炎患者血清游离IGF 1水平分别为 (0 2 3± 0 18)ng ml、(0 37± 0 2 4)ng ml和 (1 15± 0 72 )ng ml,慢性重型肝炎、肝硬化患者明显较慢性肝炎低。 5例血清游离IGF 1<0 2ng ml的慢性重型肝炎患者均死亡 ,4例 >0 3ng ml者存活 ,3例在 0 2～ 0 3ng ml之间 ,其中 2例死亡 ,1例好转。白蛋白在 30g L以下患者的血清游离IGF 1浓度显著低于白蛋白在 31g L以上的患者。结论　血清游离IGF 1水平与病情程度、白蛋白合成有密切相关 ,并可作为判断慢性重型肝炎预后的一个重要指标 Objective To detect the changes of serum free insulin - like growth factor 1 (IGF - 1) levels in patients with chronic viral hepatitis, cirrhosis and chronic severe hepatitis, and to analyze the relationship between IGF1 and the patient ’s condition and prognosis. Methods The levels of serum free IGF 1 in 43 cases of chronic hepatitis, 20 cases of cirrhosis and 12 cases of chronic severe hepatitis were detected by enzyme linked immunosorbent assay (ELISA), and compared with the indexes of liver function. Results Serum levels of free IGF1 in patients with chronic severe hepatitis, cirrhosis and chronic hepatitis were (0 2 3 ± 0 18) ng ml (0 37 ± 0 2 4) ng ml and (1 15 ± 0 72) ng ml respectively, Chronic severe hepatitis, liver cirrhosis patients were significantly lower than chronic hepatitis. Five patients with chronic severe hepatitis with serum free IGF1 <0 2 ng ml all died, 4 cases> 0 3 ng ml survived, 3 cases were between 0 2 and 0 3 ng ml, 2 of them died and 1 case improved. Serum free IGF1 concentrations were significantly lower in patients with albumin below 30 g L compared to patients with albumin above 31 g L. Conclusions The level of serum free IGF 1 is closely related to the severity of disease and albumin synthesis, and may be used as an important index to judge the prognosis of chronic severe hepatitis