一氧化氮和内皮素与肝硬化并肝肾综合征患者血流动力学的关系

The relationship of nitric oxide, endothelin and hemodynamics in hepatorenal syndrome of liver cirrhosis

目的探讨一氧化氮（ＮＯ）、内皮素（ＥＴ）与肝硬化并肝肾综合征患者血流动力学的关系。方法选择２５例肝硬化合肝肾综合征（ＨＲＳ）患者为观察组，３０例肝硬化无ＨＲＳ患者为对照组，ＮＯ通过检测其代谢产物硝酸盐而间接测定，ＥＴ利用放射免疫法测定。结果ＨＲＳ患者血ＮＯ，２４小时尿ＮＯ、ＥＴ水平较无ＨＲＳ组升高，而平均动脉压（ＭＢＰ）则明显降低。血、尿ＮＯ与门脉血流量（ＰＱ）、心输出量（ＣＯ）、心脏指数（ＣＩ）、射血分数（ＥＦ）呈正相关，与ＭＢＰ呈负相关。

Aim To study the effects of nitric oxide (NO), endothelin(ET) on hemodynamics in hepatorenal syndrome(HRS) .Methods Serum NO,plasma ET, urine NO and ET of 25 cirrhosis patients with HRS and 30 cases without HRS were evaluated. Their relations to hemodynamics were analyzed. Rasults The content of serum NO, and urine NO and ET of 24h were increased in HRS; cardiac output(CO), cardiac index(CI), ejetion fraction(EF) and portal blood flow quantity (PQ) were higher in HRS than those in cirrhosis without HRS, but the MBP of HRS was significantly lower than that in cirrhosis without HRS. Serum and urine NO were positively relative to N, CO, CI and EF, but negatively relative to MBP.Comclusion NO could lead to HRS by making hyperdynemic and higher portal flow volume.