脑脊液β—内啡肽、血管加压素含量变化与肝性脑病的关系研究

Study on the concentrations of β-endorphin and argovasopressin in cerebral spinal fluid in patients with hepatic encephalopathy

目的:为探讨脑肠肽(BGP)在肝性脑病(HE)发生和发展中的作用。方法:应用放射免疫法测定了10例HE患者和10例健康对照者脑脊液(CSF)β—内啡肽(β—EP)和精氨酸加压素(AVP)含量。结果:HE患者CSF中β—EP含量明显减低(P<0.005);AVP含量与CSF压力呈显著负相关(P<0.001);β—EP、AVP含量与CSF糖、蛋白水平无明显关系(P>0.005);β—EP含量与HE程度和预后关系密切(P<0.05)。结论:BGP可能参与HE的发生机理并能从CSF中反应出来;HE患者的一些中枢神经系统症状可能与神经元释放BGP异常有关。

AIM The effect of brain-gut peptide(BGP)on the occurence and development of hepatic encephalopathy(HE)was studied.METHODS The cerebral spinal fluid(CSF)pressure was measured and CSF was collected for routine biochemical and bacteriologicalexaminations and for radioimmunoassay of argovasopressin(AVP)and β-endorphin(β-EP)in 10 patients with Ⅰ-Ⅲ grades ofHE and in 10 normal controls.RESULTS The concentration of β-EP was significantly decreased(P < 0.005)in HE patients compared with controls.Asignificantly negative correlation was found between the concentration of AVP and the pressure of CSF in HE patients(P<0.001).No correlation was found between the concentrations of β-EP and AVP,and the concentrations of glucose and protein in CSF(P >0.05).A close correlation was also found between decreased β-EP concentration in CSF and the degree of HE(P < 0.05),andpoor prognosis(P<0.05)in HE patients.CONCLUSIONS BGP may participate in the pathogenesis of HE and can be reflected in CSF.Some central neurous systemmanifestrations in patients with HE may be related to abnormal BGP release from neurons.