肝性脑病患者血清一氧化氮水平的研究

STUDY ON THE LEVEL OF NITRIC OXIDE IN SERA OF THE PATIENTS WITH HEPATIC ENCEPHALOPATHY

目的 :观察一氧化氮 (NO)水平与肝性脑病的关系。方法 :确诊的肝性脑病 30例 ,禁食蛋白质 ,空腹抽血 ,经重氮化反应法测量血清中的NO水平 ,与 30例确诊的慢性肝炎血清中的NO水平比较 ;并比较不同时期患者血清中的NO水平。结果 :①肝性脑病患者血清NO值为 (10 5.9± 2 9.5) μmol/L ,慢性肝炎患者血清NO值为 (6 7.5± 18.9) μmol/L ,两者相比有显著性差异 (P <0 .0 1) ;②肝性脑病昏睡期和昏迷期血清NO值为 (12 2 .1± 2 5.3) μmol/L ,较前驱期和昏迷前期患者血清NO值 (87.4± 2 2 .6 ) μmol/L为高 (P <0 .0 1) ;③肝性脑病患者血清NO值与血氨值进行相关性分析无明显相关性。结论 :肝性脑病患者血清NO值明显增高 ,并随着肝性脑病的严重程度加重而增加 ,提示NO水平增高可能是肝性脑病发病的有关因素之一。

Objective:To observe the relationship between nitric oxide and hepatic encephalopathy.Methods:Nitric oxide were detected by enzyme reduction assay from the sera of 30 cases of the patients with hepatic encephalopathy and compared with that of chronic virus hepatitis.The level of nitric oxide in different periods of hepatic encephalopathy was compared,too.Results:①The level of nitric oxide in sera of the patients with hepatic encephalopathy was (105.9±29.5)μmol/L,which was significantly different from those in sera of the patients with chronic virus hepatitis (67.5±18.3)μmol/L(P<0.01);②Among the patients with hepatic encephalopathy the level of nitric oxide in sera of Lethargy and Coma periods was (122.1±25.3)μmol/L,which was higher than that of Prodromal and Precoma periods,(87.4±22.6)μmol/L(P<0.01);③In the sera of the patients with hepatic encephalopathy ,the degree of relationship of nitric oxide and ammonia levels were nearly zero correlation.Conclusion:Nitric oxide in sera of the patients with hepatic encephalopathy is higher than that of the patients with chronic virus hepatitis,and increases as serious as hepatic undergoing.The results indicate that the higher nitric oxide level might be one of the causes of hepatic encephalopathy.