缬沙坦对肝硬化门静脉高压症患者ET、NO、TNF-α浓度的影响及意义

Effects of valsartan on ET,NO and TNF-α in hepatic cirrhosis patients with portal hypertension and its significance

目的探讨缬沙坦对肝硬化门静脉高压症患者(PHT)ET、NO、TNF-α浓度的影响。方法36例肝硬化门静脉高压症患者,随机分为两组:对照组和治疗组,每组各18例。对照组给予常规保肝治疗,治疗组在此基础上加用缬沙坦80mg/d,疗程为1个月。治疗前后采用放射免疫法检测血浆ET、血清TNF-α浓度,硝酸还原酶法检测血清NO浓度。结果治疗组在加用缬沙坦后,ET、NO、TNF-α均较治疗前明显降低(P<0.05)。对照组治疗后ET、NO、TNF-α也有所降低,但差异无统计学意义(P>0.05)。两组治疗前后差值比较,差异有统计学意义(P<0.05)。结论缬沙坦可能通过改变血管活性物质的浓度降低肝硬化门静脉压力。

Objective To explore effects of valsartan on endothelin （ ET）, nitric oxide （NO） and tumor necrosis factor-alpha （TNF-α） in hepatic cirrhosis patients with portal hypertension. Methods Thirty-six hepatic cirrhosis patients with portal hypertension were randomized into two groups： valsartan group （n = 18 ）and control group （n = 18 ）. The patients were treated with routine treatment for 1 month in control group, while the patients were treated with valsartan（ 80 mg/d）based on routine treatment for 1 month in valsartan group. Before and after treatment, plasma ET and serum TNF-α were measured by radioimmunoassay, and serum NO concentration was measured by the method of nitric acid reductase. Results In valsartan group, the levels of ET, NO and TNF-α were significantly lower after treatment than that before treatment, respectively （ P 〈 0.05 ）. In control group, the levels of ET, NO and TNF-α after treatment were lower than that before treatment, but there was no statistically significant difference （ P 〉 0.05 ）. The difference of ET, NO and TNF-α before and after treatment was statistically significant between two groups （ P 〈 0. 05 ）. Conclusion Valsartan could reduce portal hypertension in patients with hepatic cirrhosis at some extent by changing the level of vasoactive substances.