肝硬化红细胞钠钾ATP酶、钙镁ATP酶及钠钾钙镁改变  

Changes of activities of erythrocyte membrane Na^+-K^+-ATPase and Ca^(2+)-Mg^(2+)-ATPase and concentrations of Na^+, K^+, Ca^(2+) and Mg^(2+) in erythrocytes of patients with liver cirrhosis

作　　者：王方剑[1] 刘安立[1] 曹洁[2] 卢永宏[1] 赵青娥[1] 韩升祥[1] 蒙玲[3] 

机构地区：[1]天津解放军第464医院内二科 [2]天津解放军第464医院特诊科 [3]93735部队

出　　处：《世界华人消化杂志》2006年第7期722-726,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨肝硬化时细胞内钠钾钙镁的改变及细胞膜钠钾ATP酶(NKA)、钙镁ATP酶 (CMA)活性改变在细胞内钠钾钙镁改变中的作用．方法:测定了52例肝硬化失代偿期(实验组 A)、36例代偿期(实验组B)患者红细胞及血清钠钾钙镁(RNa、RK、RCa、RMg;SNa、 SK、SCa、SMg)含量和NKA和CMA活性．以 36名健康人为对照组．结果:与对照组比较,实验组A的NKA、 CMA、RK、RMg(t=5．92,P<0．001;t=7．21, P<0．001;t=2．32,P<0．02;t=4．79,P<0．001)和买验组B的NKA、CMA、RK、RMg(t=3．83, P<0．001;t=2．53,P<0．02;t=2．03,P<0．05;t= 3．33,P<0．002)均显著降低;与实验组B比较, 实验组A的NKA、CMA活性(t=2．29,P<0．05; t=4．14,P<0．005)显著降低．与对照组比较, 买验组A的SNa、SK、SCa、SMg(t=8．25, P<0．001;t=5．73,P<0．001;t=9．82,P<0．001; t=6．15,P<0．001)显著降低;与实验组B比较, 买验组A的SNa、SK、SCa、SMg(t=6．94, P<0．001;t=5．00,P<0．001;t=5．57,P<0．001; t=5．73,P<0．001)显著降低．与Child B级组比较,Child C级组的NKA、CMA、RK、RMg、 SNa、SK、SCa、SMg(P<0．05或P<0．01) 显著降低．与非肝性脑病组比较,肝性脑病组NKA、CMA、RK、RMg、SNa、SK、 SMg(P<0．05或P<0．01)显著降低．实验组A中, 低SMg者的NKA和CMA显著低于高SMg者 (16．87±3．19 vs 19．04±3．25;109．83±13．51 vs 120．13±13．27;P均<0．05)．结论:肝硬化患者存在缺钾缺镁,且随病情加重而加重,缺钾缺镁可能为病情加重的原因之一．NKA和CMA活性降低可导致细胞内低钾低镁和钠钙蓄积．缺镁为ATP酶活性在失代偿期进一步降低的原因之一．AIM： To probe the activity changes of erythrocyte membrane Na^＋-K^＋-ATPase （NKA） and Ca^2＋- Mg^2＋-ATPase （CMA） and their effects on the concentrations of intracellular sodium, potassium, calcium and magnesium in patients with liver cirrhosis. METHODS： The erythrocyte membrane NKA and CMA activities, and the erythrocyte and serum sodium, potassium, calcium and magnesium （RNa, RK, RCa, RMg; SNa, SK, SCa, SMg） concentrations were measured in 52 patients with decompensated cirrhosis （group A）, 36 patients with compensated cirrhosis （group B） and 36 healthy individuals （controls）. RESULTS： Compared with those in control group, the activities of NKA, CMA and the concentrations of RK and RMg in both group A （t = 5.92, P 〈 0.001; t = 7.21, P 〈 0.001; t = 2.32, P 〈 0.02; t = 4.79, P 〈 0.001） and group B （t = 3.83, P 〈 0.001; t = 2.53, P 〈 0.02; t = 2.03, P 〈 0.05; t = 3.33, P 〈 0.002） were decreased significantly. Compared with those in group B, the activities of NKA and CMA in group A （t = 2.29, P 〈 0.05; t = 4.14, P 〈 0.005） were decreased significantly. The concentrations of RNa and RCa did not differ between among the three groups. In comparison with those in control group, the concentrations of SNa, SK, SCa and SMg were lowered significantly in group A （t = 8.25, P 〈 0.001; t = 5.73, P 〈 0.001; t = 9.82, P 〈 0.001; t = 6.15, P 〈 0.001）; and in comparison with those in group B, the concentrations of SNa, SK, SCa and SMg were also lowered significantly in group A （t = 6.94, P 〈 0.001; t = 5.00, P 〈 0.001; t = 5.57, P 〈 0.001; t = 5.73, P 〈 0.001）. The activities of NKA and CMA and the concentrations of RK, RMg, SNa, SK, SCa and SMg were markedly lower in patients at Child C stage than those at Child B stage （P 〈 0.01 or P 〈 0.05）. The activities of NKA and CMA and the concentrations of RK, RMg, SNa, SK and SMg were also markedly lower in patients with hepatoencephalopathy than those without hepatoencephalopathy （

关 键 词：肝硬化 红细胞 NA^+-K^+-ATP酶 CA^2+-MG^2+-ATP酶 

分 类 号：R575.2[医药卫生—消化系统]