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目的观察肝硬化患者血浆中内皮素(ET-1)、一氧化氮(NO)和可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)的水平变化及其与肝功能的关系,探讨其临床意义。方法采用放射免疫、分光光度及单克隆抗体法,分别检测肝硬化患者血浆中的ET-1、NO和sICAM-1、sVCAM-1水平并与正常对照组进行对比分析。结果肝硬化组(观察组)血浆ET-1、NO和sI-CAM-1、sVCAM均明显高于对照组。肝功能Child-Pugh分级A级与对照组之间无明显差异(P>0.05),B、C级与对照组之间差异显著(P<0.01),A、B、C级之间的差异非常显著(P<0.01)。结论肝硬化患者血浆ET-1、NO和sICAM-1、sVCAM-1水平均升高,并与肝细胞损伤、肝功能障碍呈正相关,提示血浆ET-1、NO和sICAM-1、sVCAM-1水平监测可作为临床观察肝硬化患者病变活动的重要免疫学指标,对肝硬化的早期诊断和Child-Pugh分级具有一定的参考和补充价值。
Objective To investigate the changes of plasma endothelin (ET-1), nitric oxide (NO) and soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) And its relationship with liver function, to explore its clinical significance. Methods The levels of plasma ET-1, NO and sICAM-1, sVCAM-1 in cirrhotic patients were measured by radioimmunoassay, spectrophotometry and monoclonal antibody respectively, and compared with the normal control group. Results The levels of plasma ET-1, NO and sI-CAM-1 and sVCAM in cirrhosis group (observation group) were significantly higher than those in control group. There was no significant difference (P> 0.05) between Child-Pugh grade A and control group, and there was significant difference between group B and C (P <0.01), but there was no significant difference between group A, B and C Significant (P <0.01). Conclusions The levels of plasma ET-1, NO and sICAM-1, sVCAM-1 in patients with cirrhosis are significantly increased, which are positively correlated with hepatocellular injury and hepatic dysfunction. These results suggest that plasma ET-1, NO and sICAM- Level monitoring can be used as an important immunological index for clinical observation of pathological changes in patients with cirrhosis. It has some reference and complementary value for the early diagnosis of liver cirrhosis and Child-Pugh classification.