肝肺综合征患者降钙素基因相关肽及内皮素含量检测

Plasma levels of calcitonin gene-related peptide and endothelin in patients with hepatopulmonary syndrome

目的 肝肺综合征 (HPS)的发生与血循环或肺内扩张 /收缩血管物质失衡密切相关。检测HPS患者血浆中降钙素基因相关肽 (CGRP)和内皮素 (ET)含量 ,以探讨它们在HPS发病中的作用。方法 选择经肺灌注扫描及血气分析诊断的HPS患者 16例 ,无HPS的肝硬化患者 30例 ,用放射免疫分析法测定其血浆CGRP、ET含量 ,同时以 15名健康献血员作为对照。结果 HPS组血浆CGRP[(6 5± 15 )pg/ml]、ET[(78± 2 1) pg/ml]显著高于肝硬化组 [(5 1± 15 ) pg/ml,(6 0± 14 ) pg/ml,P <0 .0 1],也显著高于对照组 [(32± 12 ) pg/ml,(36± 11)pg/ml,P <0 .0 1];肝硬化组与正常对照组比较差异也有显著性(P <0 .0 1)。线性相关分析显示 ,HPS组患者血浆CGRP及ET含量与动脉血氧分压呈显著负相关 ,与肺内分流率大小无关。结论 HPS患者血浆CGRP、ET含量增高 ,其增高可能与HPS肺内血管扩张和动脉血氧分压下降有关。

Objective It has been known that hepatopulmonary syndrome(HPS) is related to the imbalance between vasoconstrictors and vasodilators. The aim of the study is to examine the levels of plasma calcitonin gene related peptide (CGRP) and endothelin(ET) in patients with HPS for exploring their roles in HPS formation. Methods The levels of CGRP and ET were measured by radioimmunoassay in 16 cases of HPS, 30 cases of liver cirrhosis without HPS and 15 normal controls. Results The levels of plasma CGRP ((65±15)pg/ml) and ET((78±21)pg/ml) in 16 cases of HPS were significantly higher than those in liver cirrhosis (CGRP (51±15) pg/ml, ET (60±14) pg/ml) and in healthy controls (CGRP (32±12) pg/ml, ET (36±11) pg/ml) ( P <0.01). The increased concentrations of CGRP and ET in patiencs with HPS were correlated negatively with PaO 2. There were no linear correlation between the levels of CGRP and ET and pulmonary shunt ratios in case with HPS ( P >0.05). Conclusions The increase of plasma CGRP and ET is closely associated with the intrapulmonar vascular dilation of HPS and hypoxemia. The levels of plasma CGRP and ET in liver cirrhosis were significantly higher than those in healthy controls ( P <0.01).