AIM： To determine intestinal permeability, the serum tumor necrosis factor （TNF）-α level and urine nitric oxide （NO） metabolites are altered in liver cirrhosis （LC） with or without ascites. METHODS： Fifty-thr...AIM： To determine intestinal permeability, the serum tumor necrosis factor （TNF）-α level and urine nitric oxide （NO） metabolites are altered in liver cirrhosis （LC） with or without ascites. METHODS： Fifty-three patients with LC and 26 healthy control subjects were enrolled in the study. The intestinal permeability value is expressed as the percentage of polyethylene glycol （PEG） 400 and 3350 retrieval in 8-h urine samples as determined by high performance liquid chromatography. Serum TNF-α concentrations and urine NO metabolites were determined using an enzyme-linked immunosorbent assay （ELISA） and Greiss reaction method, respectively. RESULTS： The intestinal permeability index wassignificantly higher in patients with LC with ascites than in healthy control subjects or patients with LC without ascites （0.88 ± 0.12 vs 0.52 ± 0.05 or 0.53 ± 0.03, P 〈 0.05） and correlated with urine nitrite excretion （r = 0.98）. Interestingly, the serum TNF-α concentration was significantly higher in LC without ascites than in control subjects or in LC with ascites （198.9 ± 55.8 pg/mL vs 40.9 ± 12.3 pg/mL or 32.1 ± 13.3 pg/mL, P 〈 0.05）. Urine nitrite excretion was significantly higher in LC with ascites than in the control subjects or in LC without ascites（ 1170.9± 28.7 μmol/L vs 903.1 ± 55.1 μmol/L or 956.7 ± 47.7 μmol/L, P 〈 0.05）. COMCLUSIOM： Increased intestinal macromolecular permeability and NO is probably of importance in the pathophysiology and progression of LC with ascites, but the serum TNF-α concentration was not related to LC with ascites.展开更多
文摘目的:评价托伐普坦治疗肝硬化并低钠血症和肝性水肿的有效性及安全性.方法:检索Embase、Pub Med、Medline、Cochrane Library、Google Scholar、中国知网、维普、万方关于托伐普坦治疗肝硬化并低钠血症和肝性水肿的随机对照试验(RCT),提取相关研究数据,使用Rev Man5.3版软件进行系统评价和Meta分析.结果:8项随机对照试验共725例患者符合纳入标准.Meta分析结果显示与安慰剂相比托伐普坦能显著升高血清钠浓度[加权均数差(weighted mean difference,WMD)=7.36m m o l/L,95%C I:4.15-10.57,P<0.001],显著增加24 h尿量(WMD=1060.98 m L/24 h95%CI:529.43-1592.52,P<0.001),降低体质量及腹围(体质量:WMD=-1.14 kg,95%CI:-1.34--0.94,P<0.001;腹围:WMD=-2.18 cm95%C I:-3.02--1.34,P<0.001).托伐普坦与安慰剂相比对血清钾浓度、血清肌酐、心率、收缩压、舒张压的影响无差异(P>0.05)在不良反应发生率上,托伐普坦与安慰剂相比无统计学差异(RR=1.43,95%CI:0.73-2.80,P=0.300).结论:对于肝硬化并低钠血症和肝性水肿患者,托伐普坦能够在短期内提升血清钠浓度,增加尿量,减轻水肿,且不增加不良反应,是肝硬化并低钠血症和肝性水肿治疗有价值的新药物.
基金A grant from the National R&D Program for Cancer Control,Ministry of Health & Welfare,Republic of Korea,No.0520190-1
文摘AIM： To determine intestinal permeability, the serum tumor necrosis factor （TNF）-α level and urine nitric oxide （NO） metabolites are altered in liver cirrhosis （LC） with or without ascites. METHODS： Fifty-three patients with LC and 26 healthy control subjects were enrolled in the study. The intestinal permeability value is expressed as the percentage of polyethylene glycol （PEG） 400 and 3350 retrieval in 8-h urine samples as determined by high performance liquid chromatography. Serum TNF-α concentrations and urine NO metabolites were determined using an enzyme-linked immunosorbent assay （ELISA） and Greiss reaction method, respectively. RESULTS： The intestinal permeability index wassignificantly higher in patients with LC with ascites than in healthy control subjects or patients with LC without ascites （0.88 ± 0.12 vs 0.52 ± 0.05 or 0.53 ± 0.03, P 〈 0.05） and correlated with urine nitrite excretion （r = 0.98）. Interestingly, the serum TNF-α concentration was significantly higher in LC without ascites than in control subjects or in LC with ascites （198.9 ± 55.8 pg/mL vs 40.9 ± 12.3 pg/mL or 32.1 ± 13.3 pg/mL, P 〈 0.05）. Urine nitrite excretion was significantly higher in LC with ascites than in the control subjects or in LC without ascites（ 1170.9± 28.7 μmol/L vs 903.1 ± 55.1 μmol/L or 956.7 ± 47.7 μmol/L, P 〈 0.05）. COMCLUSIOM： Increased intestinal macromolecular permeability and NO is probably of importance in the pathophysiology and progression of LC with ascites, but the serum TNF-α concentration was not related to LC with ascites.
