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目的探讨肝硬化患者血浆胰高血糖素(GLU)的改变及其与肝功能损害和门脉血流动力学的关系。方法用放射免疫分析法测定42例肝硬化患者和20例对照组空腹血浆 CLU。用彩色多普勒超声测定门静脉及脾静脉的直径、流速和血流量。结果肝硬化患者门脉系统存在血流动力学异常,血浆胰高血糖素显著高于对照组。按肝功能 Child-Pugh 分级将肝硬化患者分为 A、B、C 三组,各组血浆胰高血糖素依次升高。合并腹水的肝硬化患者血浆胰高血糖素显著高于未合并腹水者。血浆胰高血糖素与门静脉和脾静脉的直径以及脾静脉的流量呈显著正相关。结论肝硬化患者血浆胰高血糖素升高反映了肝功能损害的严重程度,同时在门静脉高压的形成和发展过程中起着重要的作用。
Objective To investigate the changes of plasma glucagon (GLU) in patients with liver cirrhosis and its relationship with hepatic dysfunction and portal hemodynamics. Methods Fasting plasma CLU was determined by radioimmunoassay in 42 patients with cirrhosis and 20 controls. The diameter, velocity and blood flow of portal vein and splenic vein were measured by color Doppler sonography. Results There was hemodynamic abnormality in portal system in patients with cirrhosis and plasma glucagon was significantly higher than that in control group. According to the liver function Child-Pugh classification, patients with cirrhosis were divided into A, B, C three groups, each group of plasma glucagon in turn increased. Patients with cirrhosis with ascites plasma glucagon was significantly higher than those without ascites. There was a significant positive correlation between plasma glucagon and the diameter of portal and splenic veins and the flow of splenic vein. Conclusions Plasma glucagon elevation in patients with cirrhosis reflects the severity of hepatic impairment and plays an important role in the formation and development of portal hypertension.