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为了解血浆内皮素(ET)水平在肝硬化及其发展中的变化,初步探讨其意义,应用放射免疫均相竞争法测定70例肝炎后肝硬化患者血浆ET水平。结果示,(1)血浆ET水平在肝硬化肝功能Chile-Pugh评分分级A患者(57.7±21.5pg/ml)、B级患者(40.7±23.1pg/ml)和C级患者(25.2±18.4pg/ml)均明显低于正常人(78.4±21.9pg/ml)(P<0.01)。B级和C级患者均低于A级患者(P<0.01),C级患者低于B级患者(P<0.01)。肝硬化患者肝功能Child-Pugh评分分数与血浆ET水平呈负相关(γ=-0.465,P<0.05)。(2)有腹水的肝硬化患者血浆ET水平明显低于无腹水的患者(33.7±23.9pg/ml vs 52.6±20.3pg/ml,P<0.01)。(3)肝硬化患者血浆ET水平与血清白蛋白水平呈正相关(γ=0.446,P<0.05),与血清胆红素,尿素氮、血浆凝血酶原时间无明显相关。提示血浆ET的减少可能在肝炎后肝硬化体循环血管扩张的维持中起一定作用,是水钠潴留、腹水形成的因素之一。血浆ET水平与肝硬化的严重程度和循环高动力状态有密切关系。
In order to understand the change of plasma endothelin (ET) level in cirrhosis and its development, and to explore its significance, the plasma ET levels in 70 patients with posthepatitic cirrhosis were determined by radioimmunoassay. The results showed that (1) plasma ET levels were significantly higher in patients with liver cirrhosis with Chile-Pugh score grade A (57.7 ± 21.5 pg / ml), patients with grade B (40.7 ± 23.1 pg / ml) and patients with C / ml) were significantly lower than normal (78.4 ± 21.9pg / ml) (P <0.01). Patients in grade B and C were lower than those in grade A (P <0.01), patients in C were lower than those in grade B (P <0.01). Child-Pugh score of liver function in patients with cirrhosis was negatively correlated with plasma ET level (γ = -0.465, P <0.05). (2) Plasma ET levels were significantly lower in cirrhotic patients with ascites than those without ascites (33.7 ± 23.9 pg / ml vs. 52.6 ± 20.3 pg / ml, P <0.01). (3) There was a positive correlation between plasma ET level and serum albumin level in patients with cirrhosis (γ = 0.446, P <0.05), but no significant correlation with serum bilirubin, urea nitrogen and plasma prothrombin time. Tip reduction of plasma ET may play a role in the maintenance of vascular dilatation of cirrhosis after cirrhosis, which is one of the factors of water and sodium retention and ascites formation. Plasma ET levels are closely related to the severity of cirrhosis and circulatory hyperdynamic conditions.