急性重症胆管炎患者胆汁中内皮素及降钙素基因相关肽的检测及意义

Significance of endothelins and calcitonin gene related protein in bile in patients with acute cholangitis of severe type

目的 探讨急性重症胆管炎 (ACST)患者胆汁中内皮素 (ET)及降钙素基因相关肽(CGRP)浓度的变化及意义。方法 采用放射性免疫分析法检测了 5 5例ACST患者术中、术后 7、14d胆汁中ET及ERCP的浓度。结果 ACST患者术中胆汁ET的浓度显著高于对照组(P <0 .0 1～ 0 .0 0 1) ,病情严重程度不同的两组病例术中胆汁ET的浓度差异也有显著性(P <0 .0 5 ) ;术后胆汁中ET的浓度逐渐下降。术中胆汁CGRP的浓度显著低于对照组 (P<0 .0 1) ,术后胆汁中CGRP的浓度逐渐升高。结论 ET参与了ACST肝胆系统的病理损害过程 ,胆汁中ET的浓度与ACST病情严重程度呈正相关 ;胆汁中ET与CGRP二者间的平衡紊乱可能在ACST肝胆系统的病理损害过程中具有重要意义。

Objective To study the significance of alteration of concentration of endothelins(ET) and calcitonin gene related protein(CGRP) in bile in patients with acute choiangitis of severe type(ACST). Methods The concentration of ET and CGRP were detected by radioimmunoassay in 55 cases of ACST at openation time, and 7th, 14th day after operation. Results Compared with the control group, the concentration of ET in bile in patients with ACST was significantly higher at operation time(P<0.01～0.001). The concentration of ET in bile also showed significant difference at operation time between the 2 groups with different ACST severity(P<0.05). The concentration of ET in bile gradually reduced after operations. Compared with the control group, the concentration of CGRP in bile was signficantly lower at operation time(P<0.01). CGRP in bile gradually rose after operation. Conclusions The ET in bile has some effect on the ACST pathologic alterations. The content of ET in bile is related to the severity of ACST. The disturbance of the balance between bile ET and CGRP may contribute to the pathologic process of liver and bile duct injury in ACST.