血浆神经肽Y水平测定在判定慢性肝脏疾病病变程度及预后中的意义

Significance of pathological changes and prognosis in chronic hepatic disease by assay of plasma level of neuropeptide Y

目的:观察慢性肝脏疾病患者血浆神经肽Y(NPY)水平变化及其与病变程度和预后的关系。方法:采用放射免疫法检测17例慢性肝炎、48例肝硬化患者和21例健康人的血浆NPY水平。肝硬化不伴腹水组25例、肝硬化伴腹水而无肝肾综合征组19例、肝硬化伴肝肾综合征组4例,按Child分级Child A级20例, Child B级16例,Child C级12例。对照组共21例。结果:慢性肝炎、肝硬化不伴腹水组患者血浆NPY水平与正常对照组比较差异无显著性(P>0．05);肝硬化伴腹水组及肝肾综合征组患者血浆NPY水平明显高于正常对照组(P<0．05)。NPY水平与肝功能无相关性,与尿素氮(BUN)、肌酐(Cr)水平呈正相关(r=0．872, P<0．01;r=0．857,P<0．01)。结论:慢性肝脏疾病患者血浆NPY水平可作为评估病情和预后的指标之一。

Objective To study and analyze the significance of the changes of plasma level of neuropeptide （NPY） in the patients with chronic hepatic disease. Methods The plasma levels of NPY were determined by radioimmunoassay （RIA） in 17 chronic hepatitis patients, 48 hepatic cirrhosis patients and 2l healthy controls. 48 patients with hepatic cirrhosis were divided into three groups., hepatic cirrhosis without ascites （n=25）, hepatic cirrhosis with ascites but without hepatorenal syndrome （HRS） （n= 19）, hepatic cirrhosis with HRS （n=4）. 48 hepatic cirrhosis patients were also divided into another three groups according to liver function： Child A （n^20）, Child B （n= 16）, Child C （n= 12）. Results Compared with healthy controls , the plasma levels of NPY in chronic hepatitis patients and hepatic cirrhosis patients without aseites had not significant statistical difference （P〉0.05）; but plasma levels of NPY in patients with hepatic cirrhosis and ascites or those with HRS had significant difference （P〈0.05）. No corralation was found between plasma level of NPY and liver function, but the plasma level of NPY was correlated directly with plasma levels of BUN and Cr （r=0.872, P〈0. 01; r=0. 857, P〈0.01）. Conclusion The determination of plasma level of NPY in patients with chronic hepatic disease may be one of important indexes in evaluation of disease and prognosis.