急性重症胆管炎患者胆汁以及血液中内皮素的检测及意义

Significance of Endothelin in Bile and Blood in Patients with Acute Cholangitis of Severe Type

目的探讨急性重症胆管炎(acutecholangitisofseveretype,ACST)患者胆汁和外周血中内皮素(endothelin,ET)的变化以及与病情严重程度和预后的关系。方法42例ACST患者,其中Ⅰ级26例划为Ⅰ组,Ⅱ～Ⅳ级16例划为Ⅱ组,以15例择期单纯胆囊切除病例作对照组,于术中、术后7天、14天检测胆汁和外周血中ET浓度,对照组仅检测术中ET浓度。结果ACSTⅠ,Ⅱ组术中胆汁以及外周血ET的浓度明显高于对照组(P<0.05),且术中ACSTⅡ组胆汁以及外周血中ET的浓度明显高于ACSTⅠ组(P<0.05);胆道减压术后7天、14天胆汁和外周静脉血中ET明显下降。结论ET可作为判断ACST患者病情严重程度和预后的一项客观指标。

Objective To explore relationship between endothelin and the degree of illness ofpatients with acute cholangitis of severe type(ACST).Methods Forty two patients with ACST were dividedinto two groups (Ⅰand Ⅱ group) according to severity of illness.The patients with simple cholecystec-tomy were divided as control group.The concentration of ET in bile and blood were detected byradioimmunoassay in all cases of ACST at opertion time ,and 7th,14th after opertion; while in controlgroup just at opertion time.Results Compared the control group , the concentration of ET in bile andblood in patients of ACST was significantly higher at opertion time .The difference was significantlybetween Ⅰand Ⅱ group of ACST. The concentration of ET in bile gradually reduced after operationsConclusion This suggests that ET is tightly related with the pathologic process of ACST. So , inpatients with ACST , the dynamic measurement of ET in peripheral veinous blood can be an index for judgingthe degree of pathological damage either to the hepatobiliary