肝硬化MSCT肝脏灌注参数与血清NO、NOS及TNF-α相关性分析  

The correlation between perfusion parameters by MSCT and serum NO,NOS,TNF-αin patients with hepatic cirrhosis

作　　者：周艳玲[1] 杨正广 王强[2] 李彩英[3] ZHOU Yanling;YANG Zhengguang;WANG Qiang(The First Hospital of Shijiazhuang City,Hebei, Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第一医院,050011 [2]石家庄平安医院 [3]河北医科大学第二医院影像科

出　　处：《河北医药》2020年第14期2192-2194,共3页Hebei Medical Journal

摘　　要：目的研究肝硬化MSCT肝脏灌注参数与患者血清一氧化氮(NO)、一氧化氮合酶(NOS)、肿瘤坏死因子-α(TNF-α)水平定量之间的相关性。方法35例肝硬化患者作为肝硬化组,5例志愿者作为对照组行上腹部CT增强扫描取得灌注图像及灌注参数[血流速(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)、肝动脉分数(HAF)、到达时间(IRF-TO)]同时空腹抽血取得血清用ELISA测定TNF-α;硝酸还原酶化学比色法测定NO含量和NOS活性。并进行3组间免疫组化分析与灌注指标的相关性分析。结果肝硬化组NO、TNOS、INOS、TNF-α值均高于正常对照组,差异均有统计学意义(P<0.05)。Child A、B、C患者BF、HRF-TO水平均低于对照组,且BF、IRF-TO水平随Child分级不断降低,差异均有统计学意义(P<0.05)。Child A患者BV、PS、HAF值与对照组比较,差异无统计学意义(P>0.05)。Child B、C患者BV、PS值均低于对照组,HAF高于对照组,Child B、C患者BV、HAF比较,差异均有统计学意义(P<0.05)。NO生化学指标除对灌注参数MTT相关性较低外,余BF、BV、PS、HAF及IRF-TO等灌注参数均有较好的相关性(P<0.005);iNOS及TNF-α与BF、PS、IRF-TO及MTT、HAF、IRF-TO有相关性(P<0.05);而eNOS生化学指标与各种灌注参数无相关性(P>0.05)。结论NO、NOS、TNF-α水平增高是肝硬化严重程度评价的重要指标,肝硬化患者MSCT灌注参数与血清中NO、NOS水平具有非常好的相关性,TNF-α与灌注参数MTT具有明显副相关,表明MSCT灌注成像可以从分子水平判断肝硬化病情严重程度,具有临床应用价值。Objective To investigate the correlation between MSCT liver perfusion parameters(BF,BV,MTT,PS,HAF,IRT TO)and serum levels of NO,NOS,TNF-αin patients with hepatic cirrhosis.Methods Thirty-five patients with hepatic cirrhosis were enrolled as liver cirrhosis group,and 5 healthy volunteers were enrolled as control group.Both patients and volunteers underwent abdomen CT enhancement scan to get MSCT perfusion images and perfusion parameters(BF,BV,MTT,PS,HAF,IRT TO).Meanwhile the serum levels TNFαwere measured by ELISA,the NO content and NOS activity were detected by nitrate reductase chemical colorimetry.Moreover the immunohistochemical analysis and perfusion indexes correlation analysis were observed and compared between the two groups.Results The levels of NO,TNOS,INOS,TNFαin hepatic cirrhosis group were significantly higher than those in control group(P<0.05),however,the levels of BF,IRF TO in Child A,B,C patients were significantly lower than those in control group,moreover the lower the Child degree,the lower the levels of BF,IRF TO,with the significant differences(P<0.05).However there were no significant differences in values of BV,PS,HAF between the Child A patients and the control group(P>0.05).The values of BV and PS of Child B,C patients were significantly lower than those in control group,however the HAF levels were significantly higher than those in control group(P<0.05).There were significantly differences in BV and HAF between the Child B,C patients and the control group(P<0.05).The biochemistry index of NO has better correlations with BF,BV,PS,HAF and IRF TO(P<0.05),however,which has lower correlation with perfusion parameter MTT.Moreover the iNOS and TNF-αwere closely correlated with BF,PS,IRF TO,MTT,HAF,IRF TO(P<0.05).However the eNOS biochemistry indexes were not related with various kinds of perfusion parameters(P>0.05).Conclusion The increase of serum levels of NO,NOS,and TNF-αare the important indexes for evaluating the severity of hepatic cirrhosis.The MSCT perfusion parameters of patients

关 键 词：肝硬化 MSCT 灌注成像 灌注参数 一氧化氮 一氧化氮合酶 肿瘤坏死因子 

分 类 号：R657.3[医药卫生—外科学]