胆管结石及急性重症胆管炎患者外周血中内皮素及降钙素基因相关肽变化的意义

目的　探讨胆管结石及急性重症胆管炎 (ACST)患者外周血中内皮素 (ET)及降钙素基因相关肽 (CGRP)浓度的变化及意义。方法　采用放射免疫分析法检测了 3 0例胆管结石及 5 5例 ACST患者术中、术后 7d、14 d外周血中 ET及CGRP的浓度。结果　胆管结石得从术中至术后 14 d外周血中 ET的浓度与对照组比较差异无显著性。ACST患者术中外周血的浓度显著高于对照组 (P<0 .0 5～ 0 .0 1) ,病情严重程度不同的两组病例术中外周血 ET的浓度差异也有显著性 (P<0 .0 5 ) ;术后外周血中 ET的浓度逐渐下降。胆管结石患者从术中至术后 14 d外周血中 CGRP的浓度与对照组比较差异无显著性。 ACST患者术中外周血中 CGRP的浓度显著高于对照组 (P<0 .0 1) ,术后外周血中 CGRP的浓度逐渐下降。结论　 ACST患者外周血中 ET的浓度可以反映出肝胆系统及全身的病理损害程度 ,外周血中 ET的浓度与 ACST病情严重程度呈正相关 ;外周血中 CGRP浓度增高 ,对拮抗 ET对组织细胞的损伤 ,促进组织器官功能恢复可能起重要的作用。

SIGNIFICANCE OF ENDOTHELINS AND CALCITONIN GENE RELATED PROTEIN IN PERIPHERAL VEINOUS BLOOD IN PATIENTS WITH BILE DUCT STONES AND ACUTE CHOLANGITIS OF SEVERE TYPE

Objective To study the significanec of alteration of concentration of endothelins(ET) and calcitonin gene related protein(CGRP) in peripheral veinous blood in patients with bile duct stones and acute cholangitis of severe type (ACST).Methods The concentration of ET and CGRP were detected by radiommunoassay in 30 cases of bile duct stones and 55 cases of ACST at operation time,and 7th,14th day after operation.Results Compared with the control group,the concentration of ET in peripheral veinous blood in patients with bile duct stones was no significance,but the concentration of ET in peripheral veinous blood in patients with ACST was significantly higher at operation time(P<0.05-0.01).The concentration of ET in peripheral veinous blood also showed significant difference at operation time between the 2 groups with different ACST severity (P<0.05).The concentration of ET in peripheral veinous blood gradually reduced after operations.Compared with the control group,the concentration of CGRP in peripheral veinous blood in patients with bile duct stones was no significance,but the concentration of CGRP in peripheral blood in patients with ACST was significantly higher at operation time(P<0.01).The concentration of CGRP in peripheral blood gradually reduced after operations.Conclusion The concentration of ET in peripheral veinous blood in patients with ACST can reflect the degree of pathological damage either to the hepatobiliary or systemic systems.The content of ET in peripheral veinous blood is related to the severity of ACST;The concentration of CGRP in peripheral vienous blood rose.It plays an important role to reduce damage of contexture and promote recovery of function of organ.