门静脉高压症患者分流术围手术期血浆中NO及内皮素-1水平变化的意义

Perioperative changes of the plasma NO and ET- 1 in the patients with portal hypertension after splenorenal shunt operation

目的:了解肝硬化门静脉高压症患者分流术围手术期血浆中NO及内皮素-1(endothelin-1,ET-1)水平变化的意义。方法:用Griess法测外周血血浆中NO代谢产物NO3-浓度,用放射免疫方法测定ET-1浓度,并测术中及术后各时相的门静脉压力。结果:手术前后肝硬化门静脉高压组患者外周血NO及ET-1浓度与单纯肝硬化组及对照组比较差异均有统计学意义(P<0.05)。肝硬化门静脉高压组手术前后NO及ET-1水平下降与门静脉压下降均呈正相关(P<0.05)。结论:远端脾肾分流术可降低门静脉压力,NO及ET-1水平的增高可能对门静脉血管阻力的增加有影响,NO及ET-1在肝硬化门静脉高压症的形成中有重要意义。

Objective： To study the perioperative changes of the plasma NO and ET-1 in the patients with the portal hypertension after splenorenal shunt operation. Methods： The plasma NO and ET-1 of the perioperative period was detected in the cirrhotic patients with portal hypertension after distal splenorenal shunt,NO^-3 was masuredusing the Griesss and ET-1 by the radioimmunoassay. Results： Compared with control group and cirhosis group, plasma ET-1 and NO levels significantly increased in portal hypertension group. Compared with preoperative levels, plasma NO and ET-1 levels significantly decreased in the patients with portal hypertension after surgery （P〈 0.05）. While the decreasing of plasma NO and ET-1 levels was positive correlated with the decreasing of the portal pressure （r=0.61, P=0.034）. Conclusion： The distal splenorenal shunt can decrease the pressure of the portal vein and the plasma ET-1 levels.