摘要
目的:探讨门脉高压症出血病人血内皮素(ET)变化情况及其临床意义。方法:将66例肝硬化门脉高压症出血病人随机分为2组:Ⅰ组(n=32)为一般治疗组,Ⅱ组(n=34)为UTI治疗组,分别检测Ⅰ,Ⅱ组出血后1,2,4,7,10,14d血ET变化情况,并检测1,7,14d的肝功能。另选肝硬化门脉高压症未出血病人(n=20)作为对照组,检测血浆ET。结果:出血后7,14d,Ⅰ,Ⅱ组TBIL,ALT,AST均先升高后下降,但于出血后14d,Ⅱ组较Ⅰ组下降快(分别P<0.05,P<0.01,P<0.05)。Ⅰ,Ⅱ组出血后1d血ET浓度较对照组显著升高(P<0.01),随后逐步下降。Ⅱ组ET下降较Ⅰ组快,于出血后2,4,7d有显著差异(分别P<0.05,P<0.01,P<0.05)。出血后1d,Ⅰ,Ⅱ组ET浓度与总胆红素(TBIL)呈正相关(r=0.734,P<0.01);Ⅰ,Ⅱ组血ET下降指数与TBIL增高指数呈负相关(r=-0.486,P<0.05)。结论:门脉高压症大出血后ET升高可损害肝功能,应用UTI治疗可抑制TBIL,ALT,AST,ET等升高,起到保护肝功能的作用。
Objective To investigate variations of plasma endothelin (ET) and its clinical signifi-ance in portal hypertensive patients with esophageal variceal hemorrhage. Methods Sixty-six patients with portal hypertension were randomly divided into 2 groups. Group Ⅰ (32 patients) received general therapy and Group Ⅱ (34 patients) received general therapy and UTI after hemorrhage. The plasma ET concentration and liver function were determined at 1, 2, 4, 7,10, and 14 d after the hemorrhage. Another 20 patients without the hemorrhage were elected as the control group. Results At 7 and 14 d after the hemorrhage, the levels of TBIL,ALT and AST were elevated at first and then decreased in Groups Ⅰ and Ⅱ. The decrease of TBIL, ALT and AST levels was significantly faster in Group Ⅱ than in Group Ⅰ (P 〈0.05, P 〈0.01, P〈0.05, respectively) on 14 d after the hemorrhage. At 1 d after the hemorrhage the ET concentration was markedly increased in Group Ⅰ and Ⅱ as compared with the control group (P〈0.01). Then it was gradually decreased on 10 d after the hemorrhage. The ET concentration in Group Ⅱ was decreased more rapidly than that in Group Ⅰ on 2,4 and 7 d after the hemorrhage (P〈0.05;P〈0.01:P 〈0.05, respectively). The ET concentration was positively correlated to TBIL levels in groups Ⅰ and Ⅱ (r=0.734,P〈0.01). And the decreased index of ET concentration was negatively correlated to the increased index of TBIL (r=-0.486, P〈0.05). Conclusion The increased plasma ET in portal hypertensive patients with hemorrhage may contribute to liver injury. UTI can protect the liver function by inhibiting ALT, AST, TBIL and ET level.
出处
《中南大学学报(医学版)》
CAS
CSCD
北大核心
2005年第4期427-429,共3页
Journal of Central South University :Medical Science
关键词
肝硬化
门脉高压症
出血
内皮素
乌司他丁
portal hypertension
cirrhosis
hemorrhage
endothelin
ulinastatin