肝硬化和原发性肝癌患者腹水一氧化氮测定的临床意义

Clinical significance of detecting nitric oxide in ascites of the patients with liver cirrhosis and hepatocellular carcinoma

目的 探讨不同性质 ,腹水中一氧化氮 (NO)水平以及对自发性腹膜炎 (SBP)的诊断价值。方法 采用硝酸还原酶法和 (SBP)显色法检测 2 5例肝硬化合并SBP、2 0例肝硬化失代偿和 2 0例原发性肝癌患者腹水一氧化氮浓度。结果 SBP组NO浓度 (10 1.49± 2 7,5 2 μmol/L)显著高于肝硬化失代偿组 (39.36± 15 .2 3μmol/L) (P <0 .0 0 1)。肝癌组NO值显著高于肝硬化失代偿组 (P <0 .0 0 1)。 8例SBP死亡患者NO平均值 (12 7± 15 .89μmol/L)高于 12例存活组平均值 (89.40± 2 3.2 6 μmol/L) (P <0 .0 0 1)。 7例SBP治疗前NO值 85 .14± 2 6 .88μmol/L ,有效治疗后NO浓度显著下降(40 .14± 13.0 5 ) (P <0 .0 0 1)。结论 腹水NO检测有助于SBP诊断 ,指导治疗和预后判断。

Objective\ To investigate the significance of nitric oxide(NO) of ascites in the patients with liver cirrhosis (LC),hepatocelluar carcinoma (HCC) in the diagnosis of spontaneous bacterial peritonitis (SBP).Methods\ The NO value of ascites in 45 patients with liver cirrhosis (25 of 45 cases with SBP) and 20 patients with hepatocellular carcinoma was detected by nitrate reductase method and chromometry.Results\ The NO value of asicites in SBP group.HCC group and LC without SBP group 101.49±27.52μmol/L,64.15±15.23μmol/L and 39.36±10.83μmol/L respectively.The NO value in ascites of patients with SBP was significantly higher than that in patients without,SBP(P<0.001).The NO Value in ascites of 8 patients died with SBP and 17 survial patients with SBP were 127±15.89μmol/L and 89.40±23.26μmol/L respectively.There is a significant difference between the NO value of two groups above.In 7 patients with SBP,the NO value was 85.14±26.88μmol/L before treatment and 40.14±13.05 after treatment(P<0.01).Conclusion\ detection of NO in ascites is avaluable method in diagnosis,provids a therapeutic guide and estimatesprognosis in the patients with SBP.