肝后型门静脉高压症患者血浆前列环素含量及其影响因素分析  

Levels of plasma prostacyclin in patients with post-hepatic portal hypertension and the influencing factors

作　　者：唐哲[1] 许培钦[1] 

机构地区：[1]郑州大学第一附属医院普外科,450052

出　　处：《中华实验外科杂志》2005年第11期1346-1347,共2页Chinese Journal of Experimental Surgery

摘　　要：目的观察布-加综合征(B-CS)患者血浆中前列环素(PGI2)含量,探讨PGI2在肝后型门静脉高压症患者发病中的作用。方法采用放免法检测19例B-CS患者分流减压手术前后、21例B-CS患者口服肠道抗菌药物前后静脉血PGI2含量,光电比色法检测患者口服肠道抗菌药物前后静脉血内毒素含量。结果对照组患者血浆PGI2含量为(9.46±3.74)ng/L。分流减压手术前后,B-CS患者门静脉压力由(37.2±4.5)cmH2O下降至(25.8±4.2)cmH2O(P<0.01);血浆中PGI2含量由(17.71±6.93)ng/L下降至(12.43±3.54)ng/L(P<0.01),且其含量下降与门静脉压力下降呈正相关(r=0.54,P<0.05)。口服肠道抗菌药物前、后,B-CS患者血浆内毒素含量由(0.328±0.188)Eu/ml下降至(0.226±0.147)Eu/ml(P<0.01);而血浆PGI2含量分别为(14.08±5.54)ng/L和(14.21±4.98)ng/L,差异无统计学意义(P>0.05),但高于对照组(P<0.01)。结论布-加综合征患者血浆PGI2含量增高,且参与了门静脉的高压状态的维持。PGI2含量增高之原因部分地由于机体合成PGI2增多所致。增高的门静脉压力是刺激机体合成PGI2增多的原因之一,内毒素水平可能与机体合成PGI2增多无关。Objective To investigate the levels of plasma prostacyclin （PGI2） in patients with Budd-Chiari syndrome （B-CS） and discuss the role of PGI2 during the course of Budd-Chiari syndrome. Methods The levels of venous plasma PGI2 were measured by the radioimmunoassay in 19 patients with B-CS befre and after reduced portal venous pressure by shunt operation, and 21 patients with B-CS before and after intestinal decontamination by oral antibiotics. Results The levels of plasma PGI2 in controls were （9.46±3.74） ng/L. Before and after shunt operation, the portal venous pressure of the patients was （37.2±4.5） cm H2Oand （25.8±24.2） cm H2O （P〈0.01） and the levels of plasma PGI2 were （ 17.71±6.93） rlg/L and （ 12.43±3.54） ng/L respectively （P 〈 0.01）. There was a positive correlation between the reductions of portal venous pressure and the decrases of levels of plasma PGI2 （ r = 0.54, P 〈 0.05）. Before and after having oral antibiotics, the levels of plasma endotoxin in patients with B-CS were （0.328±0.188） Eu/ml and （0.226±0. 147） Eu/ml respectively （P〈0.01）, and the levels of PGI2 were 14.08±5.54 ng/L and （ 14.2124.98） ng/L respectively （ P 〉 0.05）, significantly higher than in controls （P 〈 0.01）. Conclusion The levels of plasma PGI2 in patients with B-CS are higher than those of healthy persons. It is most likely that this phenomenon is lying in all patients with posthepatic portal hypertension. Meanwhile, the high levels of plasma PGI2 probably play an important role in maintenance of the high pressure of portal veins. The cause of the increased levels of plasma PGI2 in patients with B-CS is partly due to high production of their bodies. The increased portal venous pressure was one of the causes which stimulated the high production of PGI2.

关 键 词：布-加综合征 前列环素 门静脉 内毒素 肝后型门静脉高压症 血浆前列环素 内毒素含量 患者血浆 影响因素分析 门静脉压力 

分 类 号：R575.2[医药卫生—消化系统]