血浆H_2S对肝硬化患者门脉侧枝循环血流的影响  

Effects of plasma hydrogen sulfide on blood stream of portal collateral vessels in patients with cirrhosis

作　　者：陈尼维[1] 孙群[1] 沈伟琳[1] 张强[1] 陆允敏[1] 

机构地区：[1]上海交通大学附属第六人民医院消化内科,上海200233

出　　处：《同济大学学报（医学版）》2009年第5期83-85,共3页Journal of Tongji University(Medical Science)

摘　　要：目的探讨肝硬化患者血浆硫化氢(H2S)对门脉侧枝循环血流的影响。方法60例肝硬化患者(Child-Pugh A、B、C级各20例)、20例正常人采用多谱勒超声测定门静脉、脾静脉及肠系膜上静脉血流参数;分光光度法检测血浆H2S的浓度。结果正常人组血浆H2S(52.82±15.43)μmol/L,高于肝硬化组(37.08±10.36)μmol/L,差异有统计学意义(P<0.05),Child-Pugh A组与Child-Pugh C组差异有统计学意义(P<0.05);肝硬化组门静脉血流量(494±286)ml/min,低于正常人组(811±186)ml/min,差异有统计学意义(P<0.05),Child-Pugh A与Child-Pugh C组差异有统计学意义(P<0.05);肝硬化组脾静脉与肠系膜上静脉血流量之和(1257±326)ml/min,高于正常人组(801±197)ml/min,差异有统计学意义(P<0.05),Child-Pugh C与Child-Pugh A组差异有统计学意义(P<0.05);肝硬化组血浆H2S与脾静脉及肠系膜上静脉血流量之和呈负相关(γ=-0.339,P<0.05)。结论肝硬化患者血浆H2S降低与肝功能有关,并可能是引起门脉侧枝血流量改变因素之一。Objective To explore the effects of plasma hydrogen sulfide （H2S ） in the blood stream of portal collateral vessels in patients with cirrhosis. Methods The parameter of portal venous flow （ PVF）, splenic venous flow （ SVF）, and superior mesenteric venous flow （SMVF） were determined by Doppler ultrasonography. Plasma H2S concentration were detected with a spectrophotometer in 60 patients with cirrhosis （20 Child-Pugh class A, 20 Child-Pugh class B, 20 Child-Pugh class C） and 20 normal controls. Results The values of plasma H2 S were significantly different between the normal controls and the subjects of cirrhosis groups（52.82 ± 15.43 μmol/L vs 37.08 ± 10.36 μmol/L, respectively, P 〈 0.05 ）, with the figure in Child-Pugh A group being markedly higher than that in Child-Pugh C group （ P 〈 0. 05 ）. Noticeably, PVF of the normal control group was markedly higher than that of the cirrhosis groups （811 ± 186 ml/min vs 494 ± 286 ml/min, P 〈 0.05 ）, while there was a significant difference in the values of PVF between Child-Pugh A and Child-Pugh C groups （ P 〈 0.05 ）. The sum of SVF and SMVF in groups of cirrhosis was ~reater than that of the normal controls （ 1 257 ±326 ml/min vs 801 ± 197 ml/min, P 〈0.05）.and there was a significant difference between groups of Child-Pugh A and Child-Pugh C （ P 〈 0.05 ）. In addition, there was a negative correlation between plasma H2 S level and the sum of SVF and SMVF in patients with cirrhosis （ γ =- 0. 339, P 〈 0.05 ）. Conclusion The correlation between plasma H2 S level and liver function possibly plays an important role in the blood stream of portal collateral vessels in patients with cirrhosis.

关 键 词：血浆硫化氢 多谱勒超声 门脉侧枝循环 

分 类 号：R571[医药卫生—消化系统]