血吸虫病人血浆血管紧张素水平检测及临床意义

Plasma angiotension-Ⅱ level and its clinical significance in patients with schistosomiasis

目的检测血吸虫病人血浆血管紧张素(AT-)水平,探讨其变化规律及病理生理方面的临床意义。方法分别对68例慢性早期血吸虫病人、75例晚期血吸虫病人、68例健康对照者进行血浆AT-水平检测,将其数据进行统计学分析。结果慢性早期血吸虫病人血浆AT-水平(69.28±16.67)pg/ml与健康人(62.29±12.98)pg/ml差异无显著性(P>0.05);晚期血吸虫病人血浆AT-水平明显增高为(612.00±120.18)pg/ml,与健康人、慢性早期血吸虫病人差异均有显著性(P均<0.01),肝功能Child-pugh各级之间,A级:(457.76±45.25)pg/ml,B级:(599.67±46.98)pg/ml,C级:(732.74±27.14)pg/ml差异亦存在显著性(P均<0.01);肝功能Child-pughA级的晚期血吸虫病人血浆AT-水平与慢性早期血吸虫病人差异有显著性(P<0.01)。结论慢性早期血吸虫病人血浆AT-水平不高;晚期血吸虫病人血浆AT-水平明显增高,且肝功能损害程度越重增高越明显。临床通过拮抗AT-,有望减轻或延缓晚期血吸虫病人肝纤维化。

Objective To explore the fluctuating regularity of angiotension- Ⅰ in plasma of patients suffered from chronic schistosomiasis and its significance in pathophysiology aspects. Methods The plasma angiotension- Ⅰ from 68 cases of chronic schistosomiasis at early stage （the first group）, 75 cases of advanced schistosomiasis （the second group） were measured by the radio immunization analysis, while another 68 healthy persons performed as the control group. Results For the angiotension-Ⅰ level, there was no significance difference between the first group （69.28 ± 16. 67） pg/ml and the control group （62.29±12.98） pg/ml （P〉0. 05）, but the angiotension- Ⅰ level in the second group was much higher（612.00± 120.18） pg/ml than those in the others （P〈 0. 01） . There were significant differences of angiotension Ⅰ level among the Child-Pugh Grade A, B and C subgroups [Grade A（457.76±45.25） pg/ml, Grade B （599.67±46.98） pg/ml, Grade C （732. 74±27.14） pg/ml], and there was a significant difference between the advanced patients with Grade A in Child-Pugh classification and the patients of the first group （P〈0.01） . Conclusions The angiotension- Ⅰ is correlated with patient＇s liver function. It increases when the liver function aggravates. At early stage of schistosomiasis, its level is normal. The study suggests that if the angiotension- Ⅰ is resisted in some degree, the process of liver fibrosis would be reduced or delayed.