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目的 探讨肝硬化患者血浆内皮素 1(ET 1)的变化及其与肝功能损伤、门脉高压和肝肺综合征(HPS)的关系。方法 用放免法和自动血气分析仪检测 2 0例正常对照者、5 0例肝硬化患者血浆ET - 1和动脉血氧分压。结果 肝硬化组血浆ET 1水平显著高于对照组。血浆ET 1与肝功能降低、门脉高压密切相关。肝硬化组肺泡 动脉血氧分压差 (AaDpO2 )显著高于对照组 ;动脉血氧分压 (PaO2 )明显低于对照组。低氧血症在肝功能C级患者最为明显 ,肝性低氧血症与门脉高压相关。相关分析显示肝硬化门脉高压患者血浆ET 1和AaD pO2 间存在明显正相关 ;血浆ET 1和PaO2 间存在负相关。结论 肝硬化患者血浆ET 1水平反映了肝硬化的严重程度。ET 1可能由肝损伤所致 ,在肝硬化门脉高压和HPS的形成过程中起重要作用
Objective To investigate the changes of plasma endothelin 1 (ET 1) and its relationship with liver injury, portal hypertension and hepatopulmonary syndrome (HPS) in patients with liver cirrhosis. Methods Plasma ET - 1 and arterial oxygen tension in 20 normal controls and 50 cirrhotic patients were measured by radioimmunoassay and automatic blood gas analyzer. Results The level of ET 1 in cirrhosis group was significantly higher than that in control group. Plasma ET 1 is associated with decreased liver function and portal hypertension. The alveolar arterial oxygen pressure difference (AaDpO2) in cirrhosis group was significantly higher than that in control group. PaO2 was lower in cirrhosis group than in control group. Hypoxemia is most evident in patients with grade C liver function, and hepatic hypoxemia is associated with portal hypertension. Correlation analysis showed that there was a significant positive correlation between plasma ET 1 and AaD pO2 in cirrhotic patients with portal hypertension. There was a negative correlation between plasma ET 1 and PaO 2. Conclusions Plasma ET 1 levels in patients with cirrhosis reflect the severity of cirrhosis. ET 1 may be caused by liver injury and plays an important role in the formation of cirrhotic portal hypertension and HPS