肝硬化患者血浆内毒素、内皮素-1和一氧化氮水平变化及相关性研究

Plasma endotoxin,endothelin-1 and nitric oxide level changes and correlation studies of patients with cirrhosis

目的探讨肝硬化患者血浆内毒素(LPS)、内皮素-1(ET-1)以及一氧化氮(NO)水平的变化,了解三者之间及它们与肝功能损害程度的关系。方法用鲎试验定量检测法,放射免疫法和硝酸酶还原法,测定65例肝硬化患者(其中ChildA、B、C级分别为19、26、20例)和29例健康人血浆LPS、ET-1以及NO水平。结果肝功能ChildA、B、C级组血浆NO水平分别为(31.27±9.55)、(53.29±10.68)、(77.35±9.63)mmol/L,ET-1水平分别为(51±15)、(75±18)、(103±16)ng/L,LPS水平分别为(0.063±0.037)、(0.203±0.079)、(0.398±0.105)Eu/mL。肝硬化患者血浆NO、ET-1及LPS水平随肝功能恶化逐渐升高。另外,随着腹水量增加,血浆NO、ET-1及LPS水平也呈递增性变化。相关性分析显示,肝硬化患者血浆LPS、ET-1和NO三者之间呈正相关。结论联合监测血浆LPS、ET-1与NO水平有助于判断肝硬化腹水患者病情,对于指导治疗,改善预后可能具有重要的临床价值。

Objective To study endotoxin（LPS）, plasma endothelin-1 （ET-1） and nitric oxide（NO） level changes of patients with liver cirrhosis plasma, understand the relationship between the three and their relationship between the liver function damage degree. Methods The plasma levels of endotoxin, endothelin-1 and nitric oxide of 65 cirrhotic patients which were divided into group A（n= 19）,B（n： 26）,and C（n= 20） according to the Child-Puch liver ruction classification standard and health people（n= 29）. All groups were measured by osis Limulus lysate test, radioimmunoassay and Griess, respectively. Results In Liver function ChildA,B,C level respectively,plasma NO levels were （31.27±9.55） ,（53.29±10.68） ,（77.35±9.63）mmol/L;ET-1 levels were （51±15）,（75±18）,（103±16）ng/L;LPS levels were （0. 063±0. 037）, （0. 203±0. 079）,（0. 398±0. 105） Eu/mL. Patients with cirrhosis plasma NO,ET-1 and LPS levels were increased with deterioration. In addition to that,with the increase of ascites plasma NO, ETa1 and LPS levels increased. Correlation analysis showed that plasma LPS, ET-1 and NO levels of patients with cirrhosis had obvious positive correlation. Conclusion Jiont detecting the levels of LPS.ET-1 and NO helps diagnosis, treatment and improve- ment of patients＇ prognosis with liver cirrhosis and may have important clinical value.