肝性脑病患者中神经介质内皮素,血栓素B_2和6-酮-前列腺素F1α的变化

Changes of neurotransmitter endothelin,thromboxance B_2 and 6-keto-prostaglandin F1 alpha in patients with hepatic encephalopathy and clinical significance

目的研究肝性脑病(HE)患者内皮素(ET),血栓素B2(TXB2)和6-酮-前列腺素F1α(6-K-PGF1α)变化及其临床意义。方法HE患者62例,其中肝炎后肝硬化43例,乙型慢性重型肝炎19例。采用放免法测定血浆ET,TXB2和6-K-PGF1α。另选献血者30例作为正常对照。结果所有患者均肝肾功能异常。与正常对照比较,无论肝硬化还是慢性重型肝炎引起的HE,血浆ET和TXB2均明显升高(P<0.01),而6-K-PGF1α则明显下降(P<0.01),但肝硬化和慢性重肝炎之间血浆ET,TXB2和6-K-PGF1α变化无差异(P>0.05)。血浆ET和TXB2升高与6-K-PGF1α降低呈负相关(r=-0.4562,P<0.05)。结论HE患者血浆ET,TXB2和6-K-PGF1α可发生明显改变,这一变化对研究HE有一定的临床意义。

Objective To explore the changes of the neurotransmitters in patients with hepatic encephalopathy （HE）and the clinical significance. Methods Sixty-two patients with HE （37 males, 25 females, mean age 61.6 years old ）were enrolled in the study, including 43 patients with post-hepatitic cirrhosis and 19 with chronic severe hepatitis B. Plasma endothelin （ET）, thromboxance B2 （TXB2 ）and 6-keto-prostaglandin F1 alpha（ 6-K-PGF1 α）were detected by radioimmunoassay. Thirty blood donors were selected as normal controls. Results Compared with the normal controls,the levels of plasma ET and TXB2 were significantly elevated （ P 〈 0.01 ） and 6-K-PGF1α lowered（ P 〈0.01 ）in the HE patients ,but there was no significant difference between the patients with post-hepatitic cirrhosis and chronic severe hepatitis B （ P 〉 0.05 ）. Elevated plasma ET and TXB2 were negatively related to the reduced 6-K-PGF1 α （r = -0.456 2, P 〈 0.05 ）. Conclusion The results indicate that apparent changes of plasma ET and ,TXB2 and 6-K-PGF1α in the HE could provide a clinical significance for studying the HE.