血管活性物质分布及其在肝肾综合征发病中的作用

Distribution of the Vascular Activated Substance And Its Function in the Development of Hepatorenal Syndrome

目的为了深入探讨肝肾综合征(HRS)的发生机制,特别是血管舒缩物质在其中的作用;方法将慢性肝炎患者按有或无合并肝肾综合征分成观察组和对照组,采用酶免法分别检测两组患者血清和腹腔积液中一氧化氮、内皮素、肾素、心房肽的含量,并进行比较。结果发现观察组血清和腹腔积液中肾素和内皮素的含量明显增高,与对照组比较有非常显著差异(P<0.01);同时观察组血清中心房肽含量明显减少,一氧化氮含量明显增加,与对照组比较也有显著差异(P<0.05),而腹腔积液中心房肽含量两组无差异,一氧化氮含量则增加。内皮素含量增高明显者,一氧化氮含量也相应增高,两者呈正相关。结论HRS的发生是综合因素参与的结果,血管舒缩物质的增减及其相互之间的调节可能占主要地位。

Objective To investigate the pathogenesis of hepatorenal syndrome （HRS）, especially the role of the vasoconstrictor that and vasodilator that played in the process,Methods The patients were divided imo two groups for observation： The patients of chronic hepatitis with FIRS were observational group, the patients of chronic hepatitis without hepatorensl syndrome were control group.Immunoenzyme technique was used for detecting the quantity of renin, atrial natruretic polypeptide, nitric oxide and endothelin in blood and ascites of all patients in two groups respectively. Then we compared the data of the two groups. Results Compared with those of the control group, rennin and endothelin in blood and ascites of the observational group increased significantly （P 〈 0.01）. At the same time, compared with those of the control group, atrial natruretic polypeptide in blood decreased significantly and nitric oxide in blood increased （P 〈0.05）. However, in two groups the levels of atrial natruretic polypeptide in ascites was approximately the same and the level of nitric oxide increased. On the other hand, the more the quantity of endothelin increased, the more the quantity of nitric oxide increased correspondingly. The two were positively correlative. Conclusions Tne incidence of the hepatorenal syndrome synthesizes all kinds of factors. It is possible that the vasoconstrictor and vasedilator increase or decrease and adjust themselves among the factors.