门奇静脉断流术对门脉高压症一氧化氮及氧自由基的影响  

Effect of transabdominal esophagogas tric decascularization with splenectomy on nitric oxide and oxygen-derived free radicals in portal hypertension

作　　者：姚常柏[1] 吴硕东[1] 夏振龙[1] 

机构地区：[1]中国医科大学第二临床学院普外科,辽宁省沈阳市110004

出　　处：《世界华人消化杂志》2002年第1期28-31,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨NO系统、OFR系统对门脉高压症(PHT)的影响及门奇静脉断流术的作用。 方法:门脉高压症患者19例,肝功能A级9例,B级10例;正常对照组15例。术前、术后d3晨空腹抽静脉血应用硝酸盐还原酶法测定NO,黄嘌呤氧化酶法测定超氧化物歧化酶(SOD),比色法测定一氧化氮和酶(NOS),硫代巴比妥酸(TBA)法测定丙二醛(MDA)。 结果:肝硬化PHT患者术前血清NO(μmol·L^(-1))含量、NOS活性(kU·L^(-1))A级分别为63.8±10.7,26.3±7.9,B级分别为79.2±14.8,36.7±9.0,较正常对照组32.7±6.2,12.5±4.1显著升高(p<0.01);术前肝功能B级NO、NOS较A级显著升高(p<0.01);门奇静脉断流术后3dNO、NOSA级分别为40.2±9.4,16.9±5.3,B级分别为58.7±12,26.6±6.5与术前比均有显著降低(p<0.05,p<0.01),但仍高于正常对照组(p<0.05,p<0.01);且门奇静脉断流术后肝功能A级的NO、NOS的下降幅度分别为37.0％,35.8％较B级的25.8％,26.3％明显。肝硬化PHT患者术前血清SOD活性(kNU·L^(-1))A、 B级分别为70.5±16.7,53.3±11.1均较正常对照组119.1±20.1显著降低(p<0.01);而PHT患者术前血情MDA含量(μmol·L^(-1))A、B级分别为21.4±4.8,32.6±6.3则显著高于对照组6.7±2.0(p<0.01);术前肝功能B级SOD、MDA与A级比也有显著性差异(p<0.01,p<0.AIM:To study the effect of nitric oxide (NO) and oxygen-derived free radicals (OFR) on portal hypertension and role of esophagogastric decascularization in splenectomy.METHODS: Among the 19 cirrhotic patients with portal hypertension, liver function was of Child's A in 9, and Child's B in the others. Fifteen patients served as normal controls. The concentrations of NO and malondialdehyde (MDA), and the activity of superoxidate dismutase (SOD) and nitric oxide aynthase ( NOS) in serum were determined, respectively by Nitrate reductase, sulfur barbituric acid (TBA), xanthine oxidase, and colorimetry preoperatively and three days postoperatively.RESULTS: Preoperatively, the serum levels of NO(μmol. L-1), NOS ( kU. L-1 ) in cirrhotic patients with portal hypertension (Child's A, 63.8 ± 10.7 and 26.3 ± 7.9, and Child's B 79.2 ± 14.8 and 36.7 ± 9.0) were significantly higher than those in control (32.7 ± 6.2, 12.5±4.1,P<0. 01) ,and those in Child's B group was significantly higher than in Child' s group A (P < 0. 01). At the third postoperative day, the levels in Child's A group (40.2 ± 9.4, 16.9±5.3)and in Child's B group (58.7±12, 26.6 ± 6.5) were significantly lower than those preoperatively (P < 0. 05, 0. 01), but significantly higher than those in controls(P<0.05,0.01). Postoperatively, the changes of NO and NOS in Child's A group (37.0% and 35.8%) were greater than those in Child' s B group (25. 8% and 26. 3%). Preoperatively, the levels of SOD (kNU. L-1) in cirrhotic patients with portal hypertension (Child' s A group, 70. 5 ± 16.7; Child' s B group 53. 3 ± 11.1) were significantly lower than that in controls (119.1 ± 20.1, P< 0.01), but the levels of MDA(μmol. L-1)(Child's A group 21.4±4.8, Child's B group 32.6 ± 6.3) were significantly higher than that in controls (6. 7 ± 2. 0, P < 0. 01). The differences of SOD and MDA between the Child's A and B groups were significant(P<0.01,0. 05). The levels of MDA at the third postoperative day (Child's A group 10.3 ±3.0 and Child's B group 20.4 ±5.7)

关 键 词：门脉高压症 一氧化氮 氧自由基 门奇静脉断流术 

分 类 号：R657.3[医药卫生—外科学]