肝硬变门静脉高压症患者肝组织一氧化氮合酶的检测及意义

The detection of nitric oxide synthase(NOS)in liver tissue from cirrhotic patients with portal hypertension and their clinicopathological significance

目的探讨一氧化氮在肝硬变门静脉高压症发病中的作用。方法采用免疫组织化学法对４２例肝硬变患者及２０例胆囊切除术患者的对照肝组织进行染色，检测肝细胞中诱导型一氧化氮合酶（ｉＮＯＳ）和内皮型一氧化氮合酶（ｅＮＯＳ）的表达，运用图像处理及分析系统对肝细胞染色进行定量分析；同时将肝硬变组按白蛋白水平分成小于３．５ｇ／ｄｌ组（２６例）和大于等于３．５ｇ／ｄｌ组（１６例），比较其肝细胞染色情况。结果肝硬变组ｉＮＯＳ染色阳性率为６９％（２９／４２），明显高于对照组的２５％（５／２０）（Ｐ＜０．０５），其中低白蛋白组染色（ＯＤ均值＝０．４４±０．０４）强于白蛋白水平正常组（ＯＤ均值＝０．３１±０．０５）（Ｐ＜０．０５）。肝硬变组与对照组ｅＮＯＳ在血管内皮细胞均少量表达，差异无显著意义。结论肝硬变肝细胞中ｉＮＯＳ过量合成。

Objective To investigate the activity of nitric oxide synthase (iNOS) in cirrhotic patients with portal hypertension.Methods Immunohistochemical method and quantitative image pattern analysis were used for the detection of the inducible nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) in the liver biopsy of 42 cirrhotic patients and 20 controls without liver disease.Patients were divided according to serum albumin level into <3 5 g/dl and ≥3 5 g/dl group,compared their staining of NOS.Results The posive staining rate of iNOS of hepatocytes in cirrhotic group was 69%(29/42),vs. 25%(5/20) in control group ( P <0 05).The iNOS staining (OD=0 44±0 04) in cirrhotic patients (26 cases) with serum albumin concentration of less than 3 5 g/dl was stronger than that in cirrhotic patients (16 cases) with the albumin concentration of 3 5 g/dl and up (OD=0 31±0 05) ( P <0 05).There was no difference in the staining of hepatocyte eNOS between the cirrhotic group and the control group.Conclusions Nitric oxide overly synthesized in hepatocytes of liver cirrhosis with portal hypertension may be associated with the liver hepatotoxicity.