肝硬化门脉高压患者血红素氧合酶—一氧化碳系统与血浆内皮素关系的初步研究  

The preliminary study of the relationship between heme oxygenase-carbon monoxide system and plasma endothelin in hepatic cirrhotic patients with portal hypertension

作　　者：刘洁[1,2] 段志军[1] 朱丽萍 杨冬[1] 王丽霞[1] 邵海燕 

机构地区：[1]大连医科大学附属第一医院消化内科,辽宁大连116011 [2]大连市第五人民医院

出　　处：《胃肠病学和肝病学杂志》2008年第9期745-748,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：辽宁省科技攻关计划项目(项目编号:00225003-4)

摘　　要：目的探讨肝硬化门静脉高压时HO-CO系统及ET变化,以及这两种血管活性物质之间是否存在相关性。方法试验对象分为3组:健康对照组20人,中、重度慢性肝炎患者组20人及肝硬化门脉高压组26人。运用双波长紫外分光光度法测定全血COHb百分比浓度以间接反映HO-CO系统水平,同时用放射免疫学方法检测血浆ET-1水平,了解二者与肝硬化门脉高压的关系及二者之间的关系。结果肝硬化门脉高压组的HO-CO水平显著高于对照组及慢性肝炎组(P<0.05),而慢性肝炎组与对照组之间的HO-CO水平无显著差异(P>0.05)。肝硬化门静脉高压组的血浆ET-1水平明显高于对照组及慢性肝炎组(P<0.05),且慢性肝炎组的血浆ET-1水平较对照组亦显著升高(P<0.05)。肝硬化门静脉高压组的HO-CO系统水平和血浆ET水平呈正相关(P<0.05)。慢性肝炎组的HO-CO系统水平和血浆ET水平无明显相关性(P>0.05)。结论HO-CO系统在肝硬化门静脉高压中发挥重要作用,但与慢性肝纤维化的程度无明显关系。血浆ET在肝硬化门静脉高压中发挥重要的生物学效应,并且与肝脏纤维化程度有关系。肝硬化门静脉高压患者的HO-CO系统水平与血浆ET水平呈正相关关系,两者共同参与维持肝硬化门静脉高压的高动力循环状态。Objective To investigate the effect of portal hypertension on HO-CO and ET in patients with cirrhotic portal hypertension, and to characterize interaction between HO-CO and ET. Methods Three groups were divided into： healthy control group （ n = 20） , patients with medium or advanced chronic hepatitis （ n = 20） , and patients with cirrhot- ic portal hypertension（n = 26）. Dual-wavelength spectrophotometry was applied to detect the blood COHb concentration to represent the level of HO-CO system, and radioimmunoassay to detect plasma ET-I level, then we couhl learn the relationship between HO-CO system and ET in patients with portal hypertension and whether there was any relationship be- tween two of them. Results The HO-CO level of patients with portal hypertension, was remarkahly higher than that of the control group and the chronic hepatitis group （P 〈 0.05 ）. Besides, there was no obvious difference between the chronic hepatitis group and the control group （ P 〉 0.05）. The ET-I level of patients with portal hypertension was remarkably higher than that of the control group and the chronic hepatitis group （P 〈 0.05）. Besides, the ET-1 level of chronic hepatitis group was also remarkably higher than that of the control group （P 〈 0.05）. The HO-CO level was positively relevant with ET level of portal hypertension patients （P 〈 0.05 ）. The HO-CO level and plasma ET level of chronic hepatitis group showed no obvious relativity. Conclusion The HO-CO system plays an important role in the portal hypertension. But it is speeulated that there is no obvious relationship between the system and chronie liver fibrosis extent. The plasma ET-1 , having a biological effect on the pathology damage to the portal hypertension, is definitely related to liver fibrosis extent. The HO-CO level and plasma ET-1 level of patients with portal hypertension are positively relevant. They may work in coordination to sustain the high dynamical circulation of portal hypertension.

关 键 词：血红素氧合酶 一氧化碳 内皮素 肝硬化 门静脉高压 

分 类 号：R575.21[医药卫生—消化系统]