肝硬化患者血浆内皮素水平

Plasma endothelin levels in patients with cirrhosis

为了解肝硬化惠者血浆内皮素水平的变化及病理生理作用,用特异性放射免疫分析法测定46例肝硬化及30例正常人血浆内皮素含量,B超测定门静脉直径。46例肝硬化患者血浆内皮素水平(82.68±26.09pg/ml)明显高于对照组(50.8±7.58pg/ml,P<0.05)。其中24例chid-pughB级(79.6±19.27pg/ml)和14例chid—pughC级(94.55±24.3pg/ml)血浆内皮素水平明显高于8例chid-pughA级(57.05±10.96pg/ml,P<0.05和P<0.01)。43例肝硬化患者血浆ET水平与门静脉直径有明显相关性(r=0.764,P<0.001)。结果提示肝硬化患者血浆内皮素水平随肝功能损害程度加重而升高,其与门脉高压的产生有一定关系。

Objective: Endothelin, a potent vasoconstricting peptide, could be involved in the regulation of hepatic microcirculation and in the development of portal hypertension. The aim of this study was to investigate the plasma levels of endothelin and its pathophysiological significance in patients with liver cirrhosis. Methods: Plasma endotheloin concentration was measured by radioimmunoassay in 46 patients with liver cirrhosis(child—pugh A in 8, child—pugh B in 24 and child—pugh C in 14)and 30 healthy controls. Ultrasonography was used to detect the portal vein diameter in 43 cirrhotic patients. Results: Plasma endothelin levels were significantly increased in patients with cirrhosis compared to healthy controls (82.68±26.09 pg/ml VS. 50.8±7.58pg/ml, mean±S.D., P<0.05). Cirrhotics with child-pugh B and child-pugh C showed higher endothelin levels than child-pugh A (79.6±19.27pg/ml and 95.55±24.3pg/ml VS. 57.05±10.96pg/ml, mean±S. D. P<0.05 and P<0.01). The plasma endothelin concentration showed that a significant positive correlation with portal vein diameter (r=0.764,P<0.001).Conclusions: Plasma endothelin levels are increased in patients with cirrhosis compared to healthy controls. The increase in plasma endothelin leveis is related to the severity of cirrhosis. Endothelin may contribute to increased intrahepatic resistance and portal pressure. Therefore, it plays an important role in aggravation of portal hypertension and esophageal variees in liver cirrhosis.