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目的 测定不同阶段肝硬化患者血浆的一氧化氮 (NO)、内皮素 (ET)及内毒素水平 ,探索它们对肝硬化腹水形成和肝功能损害所起的作用及其相互关系。方法 测血浆NO的代谢产物NO- 2 浓度 (Griess法 ) ,ET - 1浓度(放免法 ) ,内毒素浓度 (鲎试验的显色基质法 )及肝功能。结果 (1 )血浆NO、ET及内毒素浓度在肝硬化各组均明显高于正常对照组 ,在有腹水组明显高于无腹水组 ;(2 )血浆NO、ET、内毒素水平随肝功能损害加重逐渐升高 ;(3)肝硬化患者血浆内毒素与NO、ET水平分别呈正相关 ,NO与ET水平呈正相关。结论 血浆内毒素、NO和ET升高可能在肝硬化病程进展中起了重要作用 ,是形成腹水的重要因素 ,三者相互依赖、相互影响的协同作用是肝硬化进展的重要机制之一
Objective To determine the levels of plasma nitric oxide (NO), endothelin (ET) and endotoxin in patients with cirrhosis at different stages and to explore their roles in the formation of cirrhotic ascites and hepatic dysfunction and their correlation. Methods Plasma concentrations of NO - 2, NO - 2, ET - 1 (radioimmunoassay), endotoxin concentrations (chromogenic matrix assay) and liver function were measured. Results (1) The levels of plasma NO, ET and endotoxin in cirrhotic group were significantly higher than those in normal control group, and were significantly higher in ascites group than those without ascites group. (2) Plasma NO, ET and endotoxin levels were positively correlated with liver function (3) There was a positive correlation between plasma endotoxin and NO and ET levels in patients with cirrhosis, and a positive correlation between NO and ET levels. Conclusions The increase of plasma endotoxin, NO and ET may play an important role in the progression of liver cirrhosis, which is an important factor in the formation of ascites. The three are interdependent and the synergistic interaction is one of the important mechanisms of the progress of liver cirrhosis