血清胃肠激素在肝硬化患者中的变化及其临床意义

The Significance of Gastrointestinal Hormone in Cirrhotic Patients

目的观察肝硬化患者胃动素(motilin,MTL)、胃泌素(gastrin,GAS)、降钙素基因相关肽(calcitoningenerelatedpeptide,CGRP)血管活性肠肽(vasoactiveinterstinalpeptide,VIP)和胰高血糖素(glucagon,Glu)血浆浓度变化,并探讨其临床意义。方法用放射免疫法测定46例肝硬化患者和26例正常人血清MTL、GAS、CGRP、VIP和Glu的血浆浓度。结果肝硬化组MTL、GAS、CGRP、VIP和Glu浓度明显高于正常对照组,肝功能ChildA、B、C级各组中浓度依次升高。肝硬化合并消化性溃疡患者血清MTL、GAS和VIP水平高于无合并消化性溃疡患者,CGRP和Glu的浓度在两者之间变化无显著性差异。但在肝硬化有腹水的患者中CGRP和Glu的浓度明显高于无腹水患者。结论血清MTL、GAS、CGRP、VIP和Glu的浓度反映肝硬化严重程度。MTL、GAS和VIP参与肝硬化合并消化性溃疡的发病过程,CGRP和Glu在门脉高压性腹水发展过程中起一定作用。

To study the levels of serum motilin（MTL）、 gastrin （GAS）, calcitonin gene-related peptide （CGRP）、vasoactive intestinal peptide（VIP） and glucagon（Glu） in cirrhotic patients and to study its clinical significance. Methods Plasma levels of GAS、MTL、CGRP、VIP and Glu were measured in 46 cirrhotics and 26 healthy subjects. Results Cirrhosis group showed significantly higher plasma GAS、MTL、CGRP、VIP and Glu levels than those in the control grope. In cirrhosis with hepatic function impairment, plasma levels of GAS、 MTL、CGRP、VIP and Glu increased, the degree of increasing being in the order of Child A, B, C. Plasma MTL、 GAS and VIP increased in cirrhosis accompanied with peptic ulcer. Plasma CGRP level in cirrhosis with ascites was higher than that without ascites. Conclusion The increase of plasma levels of GAS、MTL、CGRP、VIP and Glu denotes the severity of cirrhosis. MTL GAS and VIP further increase in cirrhosis with peptic ulcer. CGRP and Glu was significantly higher in cirrhosis with ascites. GAS、 MTL、CGRP、VIP and Glu may play important roles in the whole course of cirrhosis.