肝肺综合征患者缺氧诱导因子-1α和诱导型一氧化氮合酶水平与门脉高压血流动力学的关系

Study of HIF-1α,iNOS and hemodynamic in patients with hepatopulmonary syndrome with portal hypertension

目的，探讨肝肺综合症（HPS）患者肺内分流发生与血浆缺氧诱导因子-1α（HIF-1α）和诱导型一氧化氮合酶（iNOS）以及门脉血流动力学变化的相互关系。方法 利用彩色多普勒检测各组门静脉内径及血流速度，用对比增强超声心动图（CEE）检测各组肺内分流，采用ELISA法分别检测健康人及伴和不伴HPS肝硬化患者的血浆HIF-1α和iNOS浓度，对比各组血浆HIF-1α和iNOS水平以及门脉血流动力学的变化与肺内分流程度的关系。结果 伴有HPS肝硬化患者血浆HIF-1α和iNOS浓度高于不伴HPS组，且门静脉内径增宽，血流速度减慢，两组比较差异有统计意义（P〈0.05），并与肺内分流程度呈正相关。结论 HIF-1α和iNOS以及门静脉血流力学异常在HPS的发生中起一定的作用。

Objective To investigate the relationship between the color doppler sonography and contrast-en-hanced echocardiography（CEE） in assessment of intrapulmonary shunting in patients with hepatopulmonary syndrome and HIF-1α,iNOS and portal hemodynamic.Methoods To examine the portal vein diameter and blood flow velocity by color Dop-pler,and intrapulmonary shunting by contrast-enhanced echocardiography（CEE）.The expressions of HIF--1α and iNOS in serum were determined by ELISA in the normal,hepatocirrhosis amalgamating HPS and unamalgamating HPS separately.Comparison of HIF-1α and iNOS in plasma was carred out and relationship betweed the portal hemodynamic and the intra-pulmonary shunting was examined in three groups.Results The levels of HIF-1α and iNOS in hepatocirrhosis amalgamating HPS were higher than those in unamalgamating HPS,the diameter of poral vein dilated and the velocity of portal vein dropped,there was correlation（P〈0.05）.There were positive correlanps with intrapulmonary shunting.Conclusion The color doppler sonography and contrast-enhanced echocardiography （CEE） which reflected HIF-1α,iNOS and the hemodynamic played an role in developing of HPS and was available to early examine change of intra-pulmonary vessel.