肝硬化患者血浆胃动素、胆囊收缩素、生长抑素及其胃电的改变  

Plasma levels of motilin, cholecysto-kinin and somatostatin and gastric electrical activity in patients with liver cirrhosis

作　　者：张蓉[1] 闻勤生[1] 黄裕新[1] 赵海峰[1] 田力[1] 

机构地区：[1]中国人民解放军第四军医大学唐都医院消化内科,陕西省西安市710038

出　　处：《世界华人消化杂志》2003年第8期1230-1233,共4页World Chinese Journal of Digestology

基　　金：全军归国人员科研启动基金资助课题;No.6008

摘　　要：目的:通过测定肝硬化患者血浆胃动素(MTL)、胆囊收缩素(CCK)、生长抑素(SS)及其胃电的变化,探讨肝硬化患者胃肠功能障碍的主要机制。方法:应用放免法分别测定38例肝硬化患者和30名健康志愿者空腹血浆MTL、CCK及SS4浓度。采用美国3CPM胃电图仪观察所有入选者水负荷试验前后胃肌电活动情况,观察指标包括频率百分比、主频、餐后和餐前功率比以及运行性频谱分析。结果:肝硬化患者MTL,CCK水平较对照组明显升高(287±81ng/L,3.3±1.4ng/L vs 131±27ng/L,1.1±0.5ng/L;P<0.01,t=11.150,n=38;P<0.01,t=9.146,n=38),且不同肝功能状态时MTL、CCK水平之间差异显著(P<0.05,F=87.570;P<0.05,F=47.506),呈现Child-Pugh C级>B级>A级的趋势。血浆SS水平在Child-Pugh B级和C级患者明显升高,与对照组差异显著(67±10ng/L vs 28±13ng/L;P<0.01,t=7.652,n=16;P<0.01,t=9.428,n=12),而在Child-Pugh A级患者升高不明显。同时,Child-Pugh B级,C级患者胃电节律紊乱率明显高于对照组(P<0.01,t=-8.008,n=16;P<0.01,t=7.697,n=16; P<0.01,t=10.178,n=12;P<0.01,t=9.817,n=12),主频(P<0.01,t=7.575,n=16;P<0.01,t=-11.623,n=12)、餐后和餐前功率比(P<0.01,t=-3.987,n=16;P<0.01,t=-4.330,n=12)低于对照组,差异显著。结论:肝硬化患者胃电节律紊乱百分比较正常人明显升高。胃肠激素的变化是肝硬化患者胃运动功能障碍的重要原因之一。AIM: To investigate the mechanism of gastrointestinal dys- function in patients with liver cirrhosis (LC) by dotermining the plasma levels of motilin (MTL), cholecystokinin (CCK) and somatostatin (SS) and gastric electrical activity. METHODS: Plasma levels of MTL, CCK and SS were de- termined with radioimmunoassay in 38 LC patients and 30 healthy volunteers. Gastric electrical activities in all the 68 subjects were observed with the electrogastrograph (3 CPM, USA) before and after water load tests. The indexes of the gastric electrical activities included the percentage of frequency, the main frequency, the ratio of power of postprandial to preprandial, and the frequency spectrum analysis. RESULTS: Compared with those in the control group, the levels of MTL and CCK in LC patients were increased (287±81 ng/L. 3.3±1.4 ng/L vs 131±27 ng/L. 1.1±0.5 ng/L. P<0.01, t=11.150, n=38; P<0.01, t=9.146, n=38). There was a significant difference between the levels of MTL and CCK with different liver functions (P<0.05, F=87.570; P<0.05, F=47.506). The levels of MTL and CCK tended to increase with the liver function from Child-Pugh A to B to C. The levels of SS in LC patients with Child-Pugh B and C liver function were increased, which showed a significant difference compared with those in the control groups (67±10 ng/L vs 28±13 ng/L. P<0.01,t=7.652,n=16; P<0.01,t=9.428,n=12).But the levels of SS in the patients with Child-Pugh A were not apparently increased.At the same time,the degree of disorder of gastric electrical activity in the patients with Child-Pugh B and C of liver function was higher than that in the control group(P<0.01.t=-8.088,n=16;P<0.01, t=7.697,n=16;P<0.01,t=-10.178,n=12; P<0.01, t=9.817,n=12).The main frequency(P<0.01,t=-7.575, n=16;P<0.01,t=-11.623,n=12)and the ratio of post- prandial power to preprandial power(P<0.01,t=-3.987, n=16;P<0.01,t=-4.330,n=12)in patients with Child- Pugh B and C of liver function were lower than that in the control group CONCLUSION: The percentage of disorder of gastric elec

关 键 词：肝硬化 血浆 胃动素 胆囊收缩素 生长抑素 胃电 胃肠功能障碍 

分 类 号：R575.2[医药卫生—消化系统]