合并腹水的门静脉高压症患者门腔静脉分流术前后血中肾素活性的变化  

The changes of plasma renin activity in cirrhotic patients with ascites undergoing portacaval shunt

作　　者：张忠明[1] 冷希圣[2] 冯洪强[3] 张卫峰 潘涛 杜如昱[2] 

机构地区：[1]解放军第二五二医院普外科,保定071000 [2]北京大学人民医院外科 [3]解放军石家庄医学高等专科学校外科教研室

出　　处：《中华普通外科杂志》2001年第7期395-396,共2页Chinese Journal of General Surgery

摘　　要：目的　探讨合并腹水的门静脉高压症患者门腔静脉分流术前后肾素活性 (PRA)水平的变化。方法　应用放射免疫分析法测定 16例患者在门腔静脉分流术前后门静脉及外周动、静脉血中PRA水平 ,分析其与门静脉压力 (PVP)变化的相关性。结果　 (1)分流术后 7dPVP水平为 (2 6±4)cmH2 O ,显著低于术前的 (36± 4)cmH2 O ,P <0 0 1。 (2 )分流术后动脉、外周静脉及门静脉血中PRA水平 (ng·ml-1·h-1)较术前显著下降 ,即 (0 8± 0 4)对 (1 8± 0 6 )、(0 8± 0 3)对 (1 9± 0 7)及 (0 8±0 3)对 (2 2± 1 0 ) ,P值均 <0 0 1。 (3)分流术前后门静脉血PRA水平与PVP变化呈显著正相关 (r =0 5 6 ,P <0 0 1)。结论　肝硬化腹水患者行门腔静脉分流术后血浆中PRA水平明显降低。Objective To observe the changes of plasma renin activity (PRA)in cirrhotic patients with ascites after portacaval shunt. Method Portal vein, artery,and peripheral vein PRA levels were measured in 16 cirrhotic patients with ascites during perioperative period of portacaval shunt. Results were compared with that in 16 cases of GI tract carcinoma.Results Z] (1)Measured at postshunt day 7,the portal venous pressure (PVP) was significantly lower than that preoperatively〔(26±4)?cm?H 2O vs. (36±4)?cm?H 2O, P <0 01〕.(2)Postshunt arterial,peripheral vein and portal vein level of PRA significantly decreased 〔(0 8±0 4) vs. (1 8±0 6),(0 8±0 3) vs. (1 9±0 7) and (0 8±0 3) vs. (2 2±1 0),all P <0 01〕. (3) Changes of PRA level were positively correlated with that of PVP ( r =0 56, P <0 01).(4)There were not significant changes in PRA in GI cancer patients perioperatively. (1)Measured at postshunt day 7,the portal venous pressure (PVP) was significantly lower than that preoperatively〔(26±4)?cm?H 2O vs. (36±4)?cm?H 2O, P <0 01〕.(2)Postshunt arterial,peripheral vein and portal vein level of PRA significantly decreased 〔(0 8±0 4) vs. (1 8±0 6),(0 8±0 3) vs. (1 9±0 7) and (0 8±0 3) vs. (2 2±1 0),all P <0 01〕. (3) Changes of PRA level were positively correlated with that of PVP ( r =0 56, P <0 01).(4)There were not significant changes in PRA in GI cancer patients perioperatively.[WT5”HZ]Conclusion The levels of PRA decreased significantly in cirrhotic patients with ascites after portacaval shunt.

关 键 词：门脉高压症 腹水 门腔分流术 肾素 

分 类 号：R657.34[医药卫生—外科学] R442.5[医药卫生—临床医学]