前列地尔对肝肾综合征患者血浆TNF-α、NO及内毒素水平的影响  

The influence of prostaglandin to plasma tumor necrosis factor-α,nitric oxide and endotoxin in patients with hepatorenal syndrome

作　　者：殷艳天[1] 王立蓉[1] 蔡莉静[1] 于皆平[2] 

机构地区：[1]东南大学附属南京市第二医院消化科,江苏南京210003 [2]武汉大学人民医院

出　　处：《胃肠病学和肝病学杂志》2009年第3期233-235,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的观察前列地尔对肝肾综合征患者血浆TNFα-、NO及内毒素水平的影响。方法选择肝硬化合并肝肾综合征患者80例,健康体检者40例。肝硬化合并肝肾综合征组80例随机分为两组:对照组40例,试验组40例。对照组给予常规的保肝、退黄、支持治疗,试验组在对照组治疗基础上每日加用前列地尔20μg,连用2周。检测各组患者血浆TNFα-、NO及内毒素水平。应用ELISA双抗体夹心法检测血浆TNFα-,亚硝酸盐还原酶法检测血浆NO,采用鳖试验检测血浆内毒素。结果对照组、试验组治疗前血浆TNFα-、NO及内毒素水平较健康体检组显著升高(P<0.05);对照组、试验组之间无显著性差异(P>0.05);试验组治疗前后血浆TNFα-、NO及内毒素水平有显著差异(P<0.01);试验组治疗后血浆TNFα-、NO及内毒素水平明显低于对照组治疗后水平,有显著差异(P<0.05)。结论前列地尔可以显著降低肝硬化合并肝肾综合征患者血浆TNFα-、NO及内毒素水平,是治疗肝硬化合并肝肾综合征的作用机制之一。Objective To observe the influence of prostaglandin to plasma tumor necrosis factor-α （TNF-α）, nitric oxide （NO） and endotoxin in patients with hepatorenal syndrome （ HRS）. Methods Eighty patients with hepatorenal syndrome were randomly assigned to two equal groups： test group and control group. Forty healthy volunteers were enrolled. Standard medical treatment was arranged to control group and an additional dosage of prostaglandin 20 μg once a day for two weeks was added to every patient in test group. Plasma tumor necrosis factor-α, nitric oxide and endotoxin in every group were measured. Plasma tumor necrosis factor-α was measured with solid-phase-enzyme linked immunosorbent assay （ELISA）. Plasma nitric oxide was measured with nitrite reductase method and plasma endotoxin was measured with Limulus test. Results Plasma levels of tumor necrosis factor-α, nitric oxide and endotoxin in patients with HRS in test group and control group before treatment were significantly higher than that in healthy volunteers （P 〈 0.05 ）. No significant difference was indicated between test group and control group （P 〉 0.05 ）. Plasma levels of tumor necrosis factor-α, nitric oxide and endotoxin were significantly decreased after prostaglandin injection in test group （P 〈 0.01）. Furthermore, plasma levels of tumor necrosis factor-α, nitric oxide and endotoxin were also significantly lower after prostaglandin injection in test group than that in control group （P 〈 0.05）. Conclusion Prostaglandin can reduce the levels of plasma tumor necrosis factor-α, nitric oxide and endotoxin in patients with hepatorenal syndrome, which may be involved in the mechanism of hepatorenal syndrome treatment.

关 键 词：前列地尔 肝肾综合征 肿瘤坏死因子 一氧化氮 内毒素 

分 类 号：R575.3[医药卫生—消化系统]