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慢性或暴发性肝衰竭常伴有外周血管总阻力减低和高动力性循环。引起这种心血管功能异常的因素仍不清楚。为了研究其发病是否与肝衰竭时血浆中物质P(substance P,SP)积聚有关,作者测定了18例肝昏迷病人的血浆免疫反应性SP(i-SP),以10例无肝病的其他危重病人和16名健康人作对照。同时测定血浆去甲肾上腺素和肾上腺素浓度。 18例中男13、女5例,平均年龄48±4.3岁。18例中急性肝细胞衰竭4例,包括暴发性肝炎2例,氟烷和条蕈中毒各1例;肝硬化13例包括慢性肝炎3例,酒精性肝硬化10例;半肝切除术1例。12例入院后病情恶化死于肝昏迷;6例好转。6例出现肾功能不全。除3例存活者外,全部均经活检或尸检证实
Chronic or fulminant liver failure is often accompanied by reduced peripheral vascular resistance and hyperdynamic circulation. The factors that cause this abnormal cardiovascular function remain unclear. In order to investigate whether its pathogenesis is related to the accumulation of substance P (SP) in liver during liver failure, the authors measured plasma immunoreactive SP (i-SP) in 18 patients with hepatic coma and 10 other patients with no risk of liver disease The patient and 16 healthy people as a control. Plasma norepinephrine and epinephrine concentrations were also determined. 18 cases of male 13, female 5 cases, the average age of 48 ± 4.3 years. Eighteen cases of acute liver failure in 4 cases, including two cases of fulminant hepatitis, halothane and mycosis poisoning in 1 case; cirrhosis in 13 cases, including chronic hepatitis in 3 cases, alcoholic cirrhosis in 10 cases; hemihepatectomy in 1 case . Twelve patients died of hepatic coma after worsening admission; 6 patients improved. 6 cases of renal insufficiency. Except 3 survivors, all were confirmed by biopsy or autopsy