血浆 VIP 对食管动力及食管静脉曲张破裂出血影响

目的：探讨肝硬化患者血浆血管活性肠肽（VIP）对食管动力及食管静脉曲张破裂出血（EVB）的影响。方法：本文采用放免法（RIA）测定64例肝硬化食管静脉曲张（EV）患者和30例健康人（HS）的血浆VIP含量；用核素扫描测定食管液体通过时间和胃食管返流（GER）；检查后其中22例食管动力异常的患者给予多潘立酮10mg tid、法莫替丁20mg bid口服，并随访1年。结果：EV组血浆VIP含量显著高于HS组（P＜0．01）；EV食管动力异常组血浆VIP含量显著高于EV食管动力正常组（P＜0．01）；EV食管动力异常非治疗组出血率显著高于EV食管动力正常组（P＜0．05）；EV食管动力异常非治疗组出血率显著高于EV食管动力异常治疗组（P＜0．05）；结论：肝硬化患者血浆VIP含量的升高可能引起食管动力异常而增加EVB机会。

The Influence of Plasma VIP on Esophageal Motility and Esophageal VaricesBleeding of Cirrhotic Patients

Objective: To explore the relation between vasoactive intestinal peptide (VIP) and esophageal motility and cir-rhotic patients with esophageal varices bleeding (EVB). Methods: Esophageal liquid transit time and gastroesophageal reflux (GER) with scintigraphy were detected in 64 cirrhotic patients with esophageal varices(EV) and 30 healthy subjects (HS). Plasma VIP concentration were measured with radioimmunoassay (RIA): Domperidone 10 mg tid p. o and famotidine 20 mg bid p.o were given in 22 patients with esophageal motility abnormality. The patients were followed up for one year. Results: Plasma VIP concentration were significantly different between the EV group and HS group(P<0.01) ;there were also significantly different between the normal esophageal motility group and abnormal motility group in plasma VIP concentration(P< 0.01): Bleeding rate were significant difference between abnormal esophageal motility group and normal motility group(P< 0.05): Bleeding rate of non treatment group with esophageal motility abnormality were markedly higher than that of treatment group(P<0.05). Conclusion: High level of plasma VIP may cause esophageal motility abnormality and EVB.