一氧化氮在梗阻性黄疸患者肝损伤中的作用及其意义  

Effect and clinical significance of nitric oxide on hepatic injury of obstructive jaundice

作　　者：郭宇廷 周怀文[2] 余秀专[2] 张剑[2] 

机构地区：[1]中国人民解放军四十四医院,550009 [2]贵阳医学院附属医院肝胆外科,550004

出　　处：《贵州医药》2004年第3期200-203,F002,共5页Guizhou Medical Journal

摘　　要：目的探讨一氧化氮在梗阻性黄疸患者肝损伤中的作用及其意义。方法选取阻塞性黄疸患者 30例作为实验组 ,另选取同期住院的单纯性胆囊结石患者 30例作为对照组。观察各组血清一氧化氮 (NO)、肿瘤坏死因子 (TNF)、谷草转氨酶 (GOT)、谷丙转氨酶 (GPT)、胆红素 (TBil)、白蛋白及血浆内毒素水平变化。取阻塞性黄疸患者肝组织作成 10 %生理盐水匀浆 ,计算每克 (湿重 )肝组织NO -2 含量 ;取材同上 ,制作石蜡切片HE染色 ,计算机图像分析仪计算HE染色切片肝细胞坏死面积。相关分析肝组织坏死面积与肝组织NO含量的相关关系。结果实验组一氧化氮、内毒素、肿瘤坏死因子水平较对照组差异有显著性 (P <0 .0 1) ;肝组织坏死面积与NO含量之间呈显著正相关 ;血清NO含量与血清谷草转氨酶 (GOT)、谷丙转氨酶 (GPT)、胆红素 (TBil)之间呈显著正相关。结论梗阻性黄疸患者一氧化氮水平显著升高 ,体内一氧化氮水平的高低与肝损伤程度相平行 ,抑制或促进一氧化氮的合成与释放可能对肝脏起保护作用 ,检测体内一氧化氮水平可成为了解梗阻性黄疸患者肝损伤程度的重要指标之一。Objective To investigate the effects and clinical significance of nitric oxide(NO) on hepatic injury of patients with obstructive jaundice. Methods Thirty patients with obstructive jaundice were selected as experimental group and 30 cases with cholelithiasis as control group.Serum nitrite/nitratre levels in liver tissue was measured as an index for nitric oxide generation in patients.Serum GOT?GPT?TBil?tumor necrosis factor(TNF)?albumin and blood plasma endotoxin were observed.The level of nitrite/nitratre was assailed by nitric acid reductase process.The level of TNF was assailed by radioimmunoassay (RIA).A small sample of liver was obtained in patients with obstructive jaundice. Histo-morphology was observed.Hepatocellular nicrosis area was calculated by computer photograph assayor at H&E stain. Results (1)The levels of NO - 2/NO - 3?TNF?ENDOTOXIN in experimental group were significantly higher than the control group (P<0.01), (2)There was positive relationship between the hepatocellular necrosis area and the level of NO - 2/NO - 3.(3)There was positive relationship among serum NO - 2/NO - 3?TBil?GOT?GPT in experiment group.Conclusion Nitric oxide participates in the progress of hepatic injury of patients with obstructive jaundice and play an important role.

关 键 词：一氧化氮 梗阻性黄疸 肝损伤 肝损伤 阻塞性黄疸 NO 

分 类 号：R575[医药卫生—消化系统]