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目的 :了解急性重症胰腺炎患者血浆内皮素和一氧化氮与肝损害的关系。方法 :采用放免法和反相高效液相色谱法分别对 3 3例急性重症胰腺炎患者血浆总内皮素和一氧化氮水平进行动态检测。结果 :治前血浆总内皮素和内皮素 /一氧化氮比值均增高 ,治后 3天时内皮素 /一氧化氮比值更高 ,以后渐降至正常。血清总胆红素、谷氨酶丙酮酸转氨酶及乳酸脱氢酶的变化规律与内皮素 /一氧化氮比值的一致。结论 :急性重症胰腺炎时内皮素及内皮素 /一氧化氮比值增高可能是导致肝损害的重要原因之一 ,其机制可能是导致肝脏微循环障碍。
Objective: To understand the relationship between plasma endothelin and nitric oxide and liver damage in patients with acute severe pancreatitis. Methods: The levels of total endothelin and nitric oxide were assayed by radioimmunoassay (RP-HPLC) and reverse phase high performance liquid chromatography (RP-HPLC) in 33 patients with acute severe pancreatitis. Results: Before treatment, the ratio of total endothelin and endothelin / nitric oxide increased. After 3 days of treatment, the ratio of endothelin / nitric oxide was higher, then gradually decreased to normal. Serum total bilirubin, glutaminase pyruvate aminotransferase and lactate dehydrogenase changes and endothelin / nitric oxide ratio consistent. Conclusion: The increase of endothelin and endothelin / nitric oxide ratio may be one of the important causes of liver damage in acute severe pancreatitis. The mechanism may be the result of liver microcirculation disorder.