胰腺癌患者血浆中内皮素水平变化及其意义的研究

Plasma endothelin level in patients of pancreatic carcinoma and its significance

目的 检测胰腺癌患者围手术期血浆中内皮素（ｅｎｄｏｔｈｅｌｉｎ ， Ｅ Ｔ） 水平，探讨内皮素与胰腺癌的关系及其临床意义。 方法 应用放射免疫分析法对胰腺癌３４ 例（ 胰头癌２７ 例，胰体尾癌７ 例）患者血浆中 Ｅ Ｔ 水平进行测定，并对其行姑息性手术及根治性手术前后 Ｅ Ｔ 水平的变化进行观察。结果 本组胰头癌患者术前 Ｅ Ｔ 水平〔（５８ ±７） ｎｇ／ Ｌ〕明显高于胰体尾癌组〔（５１ ±４） ｎｇ／ Ｌ， Ｐ＜ ００１〕及正常人组〔（５１ ±６） ｎｇ／ Ｌ， Ｐ＜ ００１〕，在减轻黄疸的手术后胰头癌组降至（５２ ±５） ｎｇ／ Ｌ，胰体尾组降至（５２ ±３） ｎｇ／ Ｌ 与正常水平相近。根治术后，胰头癌组 Ｅ Ｔ 水平为（５５ ±３） ｎｇ／ Ｌ，胰体尾癌组为（５３ ±３）ｎｇ／ Ｌ，均较姑息手术后有所升高，但差异均无显著意义（ Ｐ＞ ００５） 。 结论 胰腺癌患者血浆中内皮素水平升高主要为合并梗阻性黄疸所致，胰腺癌虽可产生内皮素，但其可能仅是参与癌细胞间的调节作用。

Objective The purpose of this study was to determine plasma endothelin (ET) level in patients with pancreatic carcinoma, and to elucidate clinical significances of perioperative ET changes. Methods Plasma ET level was measured by radioimmunoassay in 34 patients of pancreatic carcinoma and the changes after surgical procedures were investigated. Results The ET level elevated in 27 patients with cancer in the pancreatic head 〔(58±7) ng/L〕, and is significantly higher than that in 7 patients with cancer in the distal pancreas 〔(51±48) ng/L, P <0 01〕 and the controls 〔(51±6) ng/L, P < 0 01〕.After drainage operation of the bile duct, the plasma ET concentration decreased to normal level. Conclusions It was the obstructive jaundice not the carcinoma that causes the elevation of plasma ET level in patients of pancreatic cancer.