门脉高压症患者门体分流术后血前列环素水平变化的临床观察

Clinical Observation of Prostacyclin Level after Portosystemic Shunt

初步探讨临床门脉高压症患者门体分流术后血前列环素水平的变化。方法:15例(45±12岁)乙型肝炎后肝硬化(经病理证实)门脉高压症患者中,6例行门腔静脉人造血管搭桥分流术,9例行脾肾静脉分流术。于开腹后、探查前和术后3天分别抽取股动、静脉和胃网膜右静脉血各3ml,经处理后,取血浆标本保存,3周内用放免法测定其前列环素含量。采用自身对照t检验方法作统计学分析。结果:术后门静脉和周围静脉血中前列环素含量明显低于术前含量(P <0.01和P<0.05),而且门静脉血中前列环素含量下降值与门静脉压力下降值呈正相关(r=0.74,P<0.05)。结论:肝硬变门脉高压症患者在行门体分流后,其门静脉外周静脉血中前列环素含量随门静脉压力下降而下降,并不因门体分流术后分流量的增加而升高。

Aims:To investigate the change of prostacyclin level after portosystemic shunt. Methods: In 15 patients of cirrhosis due to hepatitis, confirmed pathologically, portocaval bypass was performed in 6 cases and spleno-renal shunt was performed in 9 cases. Blood sample was taken from femoral artery, vein and right gastroepiploic vein in 1~3 days after operation to determine the level of prostacyclin (PGI2) by immunoassay within 3 weeks. As selfcontrol student's t-test of statistical analysis was used. Results: The level of preoperative PGI2 in portal vein and peripheral vein was significantly lower than that of postoperative (P<0.01 and P>0.05), the level of PGI2 in portal vein is decreased with the fall of portal pressure coincidently (r=0.74, P<0.05). Conclusions: The PGI2 level of blood in portal vein is decreased with the fall of portal pressure, but the elevation was not coincide with rise of blood flow after portosystemic shunt.