肝硬变患者门腔静脉分流术前后胰高血糖素水平的动态观察  

Plasma level of glucagon in cirrhotic patients with portal hypertension during operation of portacaval shunts

作　　者：冯洪强[1,2,3] 张忠明 冷希圣[1,2,3] 李澍[1,2,3] 朱继业 杜如昱[1,2,3] 

机构地区：[1]北京医科大学人民医院外科 [2]解放军医学高等专科学校外科教研室 [3]解放军第二五二医院普外科

出　　处：《中华外科杂志》1999年第4期222-224,共3页Chinese Journal of Surgery

摘　　要：目的研究肝硬变门静脉高压症患者行门腔静脉分流术后血浆胰高血糖素（ｇｌｕｃａｇｏｎ，Ｇｌｃ）水平的变化。方法应用放射免疫分析法测定了１６例肝硬变门静脉高压症行门腔静脉分流术和１６例对照组患者血浆Ｇｌｃ水平。结果肝硬变组Ｇｌｃ水平（ｐｇ／ｍｌ）术前、术中比术后３天、术后７天，门静脉血：（１８９２±５８７）ｐｇ／ｍｌ、（１９６１±５４２）ｐｇ／ｍｌｖｓ．（１０１９±４４８）ｐｇ／ｍｌ、（９８２±３４１）ｐｇ／ｍｌｖｓ．（Ｐ＜００１）；周围静脉血：（１８４１±４８２）ｐｇ／ｍｌ、（１８７５±４２８）ｐｇ／ｍｌｖｓ．（１０２４±３４７）ｐｇ／ｍｌ、（９５２±２４９）ｐｇ／ｍｌ，（Ｐ＜００１）；动脉血为：（１８６３±５１３）ｐｇ／ｍｌ、（１８３５±５４２）ｐｇ／ｍｌｖｓ．（１０３４±３６３）ｐｇ／ｍｌ、（９３９±３０６）ｐｇ／ｍｌ（Ｐ＜００１）；肝硬变组门静脉血中Ｇｌｃ水平与门静脉压力呈明显正相关（ｒ＝０５７，Ｐ＜００１）。结论肝硬变门静脉高压症患者的Ｇｌｃ血症与胰腺及胃肠道产生Ｇｌｃ增加和肝脏代谢Ｇｌｃ降低有关；门腔静脉分流术有助于改善肝硬变门静脉高压症患者Ｇ?Objective To investigate the plasma level of glucagon in cirrhotic patients with portal hypertension during operation of portalcaval shunts. Methods Plasma level of glucagon in the portal venous, peripherial venous and arterial blood in cirrhotic patients( n =16) and control patients( n =16) was measured by radioimmunoassay respectively. Results The glucagon ratio (pg/ml) of the hepatic cirrhosis group before, during after operation 3 days after operation, 7 days after operation was observed portal venous blood:(189 2±58 7) pg/ml,(196 1±54 2) pg/ml vs. (101 9±44 8) pg/ml,(98 2±34 1) pg/ml ( P <0 01); peripherial venous blood (184 1±48 2) pg/ml,(187 5±42 8) pg/ml vs. (102 4±34 7) pg/ml,(95 2±24 9) pg/ml ( P <0 01); arterial blood:(186 3±51 3) pg/ml,(183 5±54 2) pg/ml vs. (103 4±36 3) pg/ml,(93 9±30 6) pg/ml( P <0 01). The portal vein pressure was positively correlated to the plasma level of glucagon in portal venous blood of cirrhosis ( r =0 57, P <0 01). Conclusions Hyperglucagonemia may be caused by the decreased glucagon metabolism in cirrhotic liver and hypersecretion of pancreas and the gastrointestinal tract. Hyperglucagonemia may be amended after portalcaval shunts.

关 键 词：肝硬化 门肝高压症 门腔分流术 胰高血糖素 

分 类 号：R657.310.6[医药卫生—外科学] R657.340.4[医药卫生—临床医学]