肝性脑病患者脑脊液生长抑素和甲硫氨酸脑啡肽含量变化及意义

STUDY ON THE CONCENTRATIONS OF METHIONINE ENKEPHALIN AND SOMATOSTATIN IN CEREBRAL SPINAL FLUID IN PATIENTS WITH HEPATIC ENCEPHALOPATHY

为探讨脑肠肽（ＢＧＰ）在肝性脑病（ＨＥ）发生和发展中的作用，应用放射免疫法测定了１０例ＨＥ患者和１０例无肝性脑病对照者脑脊液（ＣＳＦ）生长抑素（Ｓｓ）、甲硫氨酸脑啡肽（ＭＥ）的含量。结果表明，ＨＥ患者ＣＳＦＭＥ含量明显减低（Ｐ＜０．０５），ＳＳ含量明显增加（Ｐ＜０．０５）。ＭＥ含量与ＨＥ程度呈显著负相关（Ｐ＜＜０．０５），与ＣＳＦ糖和蛋白含量关系不密切（Ｐ＞０．０５）。随ＨＥ患者存活时间延长，ＭＥ含量渐增加（ｐ＜０．０１）。提示ＢＧＰ可能参与ＨＥ的发生发展并能在ＣＳＦ中反应出来，ＨＥ患者的一些神经精神症状亦可能与中枢神经元释放ＢＧＰ异常有关。

o understand the effect of brain-gut peptide( BGP) on the occurance and development of hepatic en-cephalopathy we studied tha concentrations of methionine enkephalin(ME) and somatostatin(SS) in cerebral spinal fluid(CSF) by radioimmunoassay in 10 patients with hepatic encephalopathy(HE)and 10 patients without HE for controls. The results showed that the concentration of ME was significantly(P<0.05),and of SS was markedly increased(P<05)in HE patients,compared with controls.A significant negative correlation was found between the concentrtion of ME and the degree of HE(P<0.05).No correlations were found between the concen-trations of ME and the concentrations of glucose or protein in CSF (P>0.05).A close correlation was also found be-tween the concentration of ME and poor prognosis in HE patients.These findings suggest that BGP may participate in the pathogenesis of HE and increases in CSF .Some manifestrations of central nervous system in patients with HE may relate to abnormal BGP release from neurons.