肝硬化患者血激素水平的变化

目的　研究肝硬化患者血激素水平的变化。方法　选取肝硬化患者 3 0名 (研究组 ) ,慢性肝炎患者 10名 (对照组 ) ,进行肝功能、腹部B超、核素心肝血流比检查 ,化验血肾上腺素、去甲肾上腺素、肾素、血管紧张素、醛固酮、心钠素、胰高糖素、内皮素、降钙素基因相关肽。结果　肝硬化患者血肾上腺素、去甲肾上腺素值较慢性肝炎患者升高 ,两者差异有显著性 (P <0 0 5 )。两组肾素、血管紧张素、醛固酮、心钠素、胰高糖素、内皮素、降钙素基因相关肽值差异无显著性 (P >0 0 5 )。ChildA级、ChildB级、ChildC级肝硬化患者血肾上腺素、去甲肾上腺素差异有显著性 (P <0 0 5 )。不同门静脉压力、不同病程、不同腹水量肝硬化患者血肾上腺素、去甲肾上腺素差异无显著性 (P >0 0 5 )。结论　肝硬化患者血肾上腺素、去甲肾上腺素值升高 ,并与肝功能损害程度有关 ,与病程、门静脉压力、腹水量无明显相关性     

肝硬化患者血尿酸水平的变化及其意义

目的 :探讨肝硬化患者血尿酸 (UA)水平的变化及其意义。方法 :回顾性分析我院肝硬化住院患者 (摒除患有可能影响UA代谢的疾病或服用影响UA代谢的药物的患者 ) 4 2例作为研究对象。分析其UA水平的变化及UA与多种可能影响因素如年龄、性别、腹水、肝功能分级、血肌酐 (Cr)、血直接胆红素 (D BIL)等的关系。同时按上述标准选取年龄、性别无差异的对照者 42例。结果 :UA值不存在年龄、性别的差异 (P >0 .0 5 )。总UA均值为 2 2 8.2 8± 13 6.83 μmol/L ,明显低于对照组 (P <0 .0 1) ;D BIL均值为 3 1.83± 46.0 1μmol/L ,显著高于对照组 (P <0 .0 1) ;Cr均值为 90 .41±83 .43mmol/L ,与对照组差异无显著性 (P >0 .0 5 ) ;Pugh Child分级分数均值为8.86± 2 .3 1,明显高于对照组 (P <0 .0 1)。UA正常 2 8例 ,降低 12例 ,升高 2例。UA正常组与其余 2组间UA值有显著性差异 (P <0 .0 1) ,UA降低组与正常组间D BILPugh Child分级分数有显著性差异 (P各 <0 .0 5与 <0 .0 1) ,而三组间年龄、Cr均值无显著性差异 (P >0 .0 5 )。Pugh Child分级C级患者的UA值明显低于A级的患者 (P <0 .0 5 ) ;有腹水与无腹水组间的UA值无显著性差异 (P >0 .0 5 )。多因素相关分析表明UA与年龄、D BIL、Cr及Pugh Child分级分数均无     

肝硬化患者门脉系统血流动力学指标与Child-Pugh分级的相关性研究

研究肝硬化患者脾静脉和门静脉血流量及其比值(Qsv/QPv)与肝脏储备功能Child-Pugh分级的关系.采用彩色多普勒超声仪对168例肝炎后肝硬化患者(ChildA级43例,B级67例,C级58例)和59例健康成年人检测了门静脉、脾静脉的内径、流速,再计算出相关的血流量,并进行了比较分析.结果显示,随着Qsv/Qpv的升高,肝硬化患者的肝功能不断下降,各组之间比较有非常显著性差异(P＜0.01).肝硬化患者肝功能损害越重,脾静脉血流量占门静脉血流量的比值越高.如果将Qsv/Qpv的截断值定于40%,则其提示肝硬化患者肝功能下降至B级或以下的敏感性、特异性、准确性分别达80.80%、74.42%和79.17%.彩色多普勒超声测量门静脉系统及其血流动力学指标用于判断肝硬化患者的肝功能状态是一个较好的临床手段.     

血清前白蛋白、胆碱酯酶对判断肝硬化患者肝储备功能及预后的临床价值

目的　评价血清前白蛋白 (PA)和胆碱酯酶 (ChE)与肝硬化患者的肝储备功能及其预后的关系。方法　测定 41例肝硬化患者和 19例健康人的PA和ChE活性 ,并按Child分级进行比较。结果　肝硬化组PA含量、ChE活性均较正常组显著降低 ;按Child分级比较 ,肝硬化组PA含量在A级与对照组、B级与A级之间差异无显著性 ,在C级与B级之间差异有显著性 (P <0 0 5 ) ;ChE活性在ChildA级与对照组、B级与A级、C级与B级之间差异有显著性 ;合并肝性脑病者 ,其ChE活性较合并上消化道出血者和腹水者显著下降。结论　血清PA含量和ChE活性可作为反映肝储备功能、判断肝病严重程度和预后的有意义的指标     

细胞因子与乙型肝炎肝硬化肝功能分级的相关性

目的：研究观察慢性乙型病毒性肝炎（CHB）肝硬化Child-Putgh分级与血清转化生长因子-β1（TGF—β1）、血小板衍生生长因子（PDGF）和γ干扰素（IFN-γ）水平的关系。方法：采用ELISA法检测28例乙型肝炎肝硬化（简称肝硬化）患者和29例健康体检者血清TGF—β、PDGF和IFN-γ水平。肝硬化患者按Child．Pu-gh肝功能分级标准分成A、B、c3级。结果：肝硬化组患者血清TGF-β1和PDGF水平均明显高于正常对照组（P〈0．05），并且ChildB级和ChildC级患者TGF—β1和PDGF水平明显高于ChildA级（P〈0．05）；IFN．1水平明显低于正常对照组（P〈0．05），并且ChildB级和ChildC级IFN-γ水平明显低于ChildA级（P〈0．05）。结论：血清TGF—β1、PDGF和IFN-γ水平在乙型肝炎肝硬化的发生发展过程中有着重要意义，并在一定程度上反应肝硬化患者肝功能损害程度，有利于临床上对该类患者病情和预后的判断。     

肝硬化患者口服葡萄糖耐量试验的变化

目的　了解口服葡萄糖耐量试验的血糖值与肝硬化患者肝功能状况的关系。方法　 3 8例肝硬化患者按Child Pugh肝功能分级 ,分为A级 ( 10例 )、B级 ( 14例 )和C级 ( 14例 )三组。 11例健康者为对照组。抽取空腹血 2ml后 ,行糖耐量试验 ,以葡萄糖氧化酶法测定血糖浓度。结果　肝硬化各组的基础血糖浓度与对照组比较无显著差异 ,60和12 0分钟血糖浓度均显著高于对照组 (P <0 .0 0 2～ 0 .0 5 ) ,且随着肝硬化严重程度的增加 (即A级→B级→C级 ) ,血糖浓度有增高的趋势。肝硬化各组的血糖12 0 /0 值均显著高于对照组 (P <0 .0 0 1～ 0 .0 0 2 ) ,并随着肝硬化严重程度的增加而增高。 12 0分钟血糖及血糖12 0 /0 值与血清白蛋白浓度呈显著负相关 (P <0 .0 0 1) ,与血清总胆红素浓度、凝血酶原延长时间、R151CG及Child Pugh肝功能评分呈显著正相关 (P <0 .0 0 1～ 0 .0 0 5 )。结论　口服葡萄糖耐量试验的 2小时血糖值及血糖12 0 /0 值与肝硬化患者的肝功能状况密切相关 ,是反映肝硬化患者肝功能状况的良好指标 ,有一定的临床应用价值。     

肝硬化患者血清载脂蛋白APO-A-I及APO B100变化的临床意义

目的　评价肝硬化患者血清载脂蛋白APO A I及APOB10 0 的变化的临床意义。方法　对 5 0例健康人及 93例肝硬化患者的载脂蛋白APO A I,APOB10 0 用免疫透射比浊法测定。结果　肝硬化患者APO A I显著下降 (P <0 0 5 ) ,且由ChildA级到ChildC级逐渐下降 ,与血清总胆红素和白蛋白分别呈显著负相关和正相关 (r =-0 67及r =0 46,P <0 0 5 )。APOB10 0 则无上述典型变化。结论　载脂蛋白APO A I可作为肝硬化患者肝功能评价的重要指标     

肝硬化患者血清和腹水激活素A的测定

目的　观察肝硬化患者血清和腹水激活素A浓度变化及其影响因素。方法　采用ELISA法分别测定 45例肝硬化患者 (Child PughA级 10例 ,B级 2 3例 ,C级 12例 )血清和腹水激活素A ,采用ELISA法测定 2 0名正常人血清激活素A。采用标准酶法测定血清门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶 (ALT)、碱性磷酸酶 (ALP)及尿素氮。结果　肝硬化患者血清激活素A的水平 ( 2 .71ng/ml± 1.90ng/ml)较对照组 ( 0 .2 1ng/ml± 0 .15ng/ml)明显升高 (P <0 .0 1)。Child PughA、B、C级肝硬化患者血清激活素A分别为 ( 1.44± 0 .16)ng/ml、( 1.95± 0 .45 )ng/ml和 ( 3 .0 8± 0 .65 )ng/ml,各级间比较差异有显著性 (P <0 .0 1)。血清激活素A与Child Pugh分级 (r =0 .894,P =0 .0 41)、ALT(r =0 .64 7,P =0 .0 0 0 )、AST(r =0 .5 5 0 ,P =0 .0 0 0 )及ALP(r=0 .3 2 8,P =0 .0 2 8)具有正相关性。肝硬化患者腹水激活素A水平为 ( 0 .43± 0 .2 4)ng/ml,Child PughA、B、C级肝硬化患者腹水激活素A分别为 ( 0 .3 9± 0 .2 1)ng/ml、( 0 .48± 0 .2 7)ng/ml和 ( 0 .41± 0 .2 2 )ng/ml ,各级之间比较差异有显著性 (P <0 .0 1) ;腹水激活素A与血清激活素A无相关性 ;与肾功能呈负相关 (r =-0 .415 ,P =0 .0 0 3 )。结论　肝硬化     

血浆N末端B型利钠肽原水平评估肝硬化患者心功能改变及其与肝功能的关系

目的 心脏彩色多普勒超声监测肝硬化患者心脏结构和功能改变,检测肝硬化患者血浆N末端B型利钠肽原(NT-proBNP)水平,探讨NT-proBNP水平在评估心脏结构和功能改变及其与肝功能的关系. 方法 检测40例肝硬化患者及25例健康对照者的血浆NT-proBNP水平.肝硬化患者肝功能Child-Pugh分级,A级10例(A组),B级15例(B组),C级15例(C组),患者用心脏超声评估其心脏结构和功能改变.肝硬化组与对照组间比较用t检验,组间比较用单因素方差分析,相关性分析用Spearman相关检验.结果 肝硬化组NT-proBNP水平为(240.15±80.87)pg/ml,较对照组的(55.86±20.13)pg/ml明显增高,P＜0.05,差异有统计学意义;肝硬化患者不同肝功能分级组间NT-proBNP水平比较:A组和B组分别为(189.20±20.25) pg/ml、(202.34±31.20) pg/ml,与C组的(300.13±34.96) pg/ml比较明显降低,P＜0.05,差异有统计学意义;A组与B组比较差异无统计学意义(P＞ 0.05).肝硬化患者不同肝功能分级A、B、C组间,左室直径、右室直径、室间隔厚度、左室后壁厚度、主动脉瓣环直径、左室射血分数、E峰、A峰、E/A比较,差异无统计学意义(P＞0.05);不同肝功能分级各组间LAs比较:A组和B组分别为(29.83±3.76) mm、(31.78±4.05) mm,均低于C组的(35.08±3.68) mm,P＜0.05,差异有统计学意义;A组与B组比较差异无统计学意义(P＞ 0.05).相关性分析发现NT-proBNP与LAs呈正相关(r=0.535,P＜0.05),与LVPW亦呈正相关(r=0.312,P＜0.05),而与LVd、IVS、EF和E/A无相关性. 结论 肝硬化患者血浆NT-proBNP水平增高,可反映肝硬化患者潜在的心功能不全,且可反映患者的肝功能状况.     

血清PⅢP、HA、CG水平与肝硬化程度的关系

目的　探讨血清Ⅲ型前胶原肽 (PⅢP)、透明质酸 (HA)和甘胆酸 (CG)与肝硬化程度的关系。方法　对临床及CT扫描诊断的 19例慢性乙型肝炎 ,18例肝硬化ChildA级 ,17例肝硬化ChildB及C级以及 2 0例正常对照组 ,进行了PⅢP、HA、CG检测。结果　PⅢP在早期肝硬化为 3 61± 82 μg/L ,晚期肝硬化为 2 0 4± 40 μg/L ,慢性乙型肝炎为 172± 47μg/L ,后两者与前者相比 ,存在非常显著性差异 (P <0 .0 1)。HA、CG在慢性肝炎组分别为 470± 5 40 μg/L ,82 1± 75 8μg/L ,肝硬化早期组分别为 5 71± 3 69μg/L ,987± 874μg/L ,肝硬化晚期组分别为 13 96± 2 0 5 6μg/L ,2 14 6± 12 0 9μg/L ,三组间均存在非常显著性差异 (P <0 .0 1)。结论　肝硬化早期 ,PⅢP升高 ,而HA、CG在晚期肝硬化时升高。对慢性肝炎患者检测血清PⅢP、HA、CG ,有助于早期肝硬化的诊断。     

男性乙型肝炎肝硬化患者血清瘦素及血脂水平的研究

目的检测男性乙型肝炎肝硬化患者血清瘦素及血脂水平，探讨其异常变化的临床意义。方法男性乙型肝炎肝硬化患者64例，男性健康受试者28名，用ELISA法检测血清瘦素水平，用全自动生化分析仪检测肝功能和血脂。对血清瘦素、血脂与肝功能的关系进行分析。结果各组乙型肝炎肝硬化Child-Pugh分级患者与对照组比，血清瘦素水平无显著性差异（P〉0．05）；与正常对照组比，乙型肝炎肝硬化患者血CHO和LDL水平显著降低（P〈0．01），按Child分级由A到C级各组CHO和LDL水平逐渐降低，差异有显著性（P〈0．01）。无腹水肝硬化患者血清瘦素水平与BMI及Fat％均呈显著正相关。结论血清瘦素水平不能作为评价男性乙型肝炎肝硬化患者病情严重程度的指标，血清胆固醇、低密度脂蛋白是肝功能减退的指标。瘦素可能参与了男性乙型肝炎肝硬化患者的营养不良。     

Cardiac dysfunction in portal hypertension among patients with cirrhosis and non-cirrhotic portal fibrosis

BACKGROUND/AIMS: In cirrhosis, diastolic dysfunction of heart is well documented. Contribution of portal hypertension towards cardiac changes in cirrhosis is difficult to assess. We examined the patients of non-cirrhotic portal fibrosis who have portal hypertension without liver insufficiency to understand the contribution of portal hypertension in causing cardiac changes. METHODS: Cardiac function was studied in four groups of patients: normal controls, patients with non-cirrhotic portal fibrosis (having portal hypertension without liver dysfunction) and cirrhotics with and without ascites. Cardiac function was evaluated by echocardiography. Additional measurements of plasma renin activity and aldosterone levels were performed. RESULTS: Diastolic function as assessed by the ratio between E wave and A wave (E/A ratio), was significantly lower in patients with non-cirrhotic portal fibrosis (median 1.3) compared to normal controls (median 1.52). However, even lower values were observed in cirrhotics without ascites (median 1.05) and with ascites (median 0.94). There was a significant correlation (r=-0.75) between plasma aldosterone levels and the E/A ratio in cirrhotics. CONCLUSIONS: Diastolic dysfunction is not only present in cirrhosis but also in non-cirrhotic portal fibrosis. It indicates that portal hypertension is an important factor in the genesis of cardiac dysfunction.     

Clinical Characteristics of Portal Hemodynamics in Alcoholic Liver Cirrhosis

Background: Low incidence of reversal blood flow at the portal vein has been reported by measurement in larger and extrahepatic blood vessels but not in intrahepatic blood vessels in patients with liver cirrhosis. Moreover, there is little information regarding the incidence of reversal blood on the basis of the cause of liver cirrhosis. The aim of this study was to measure the reversal blood flow in the portal vein including intrahepatic branches in patients with alcoholic and viral cirrhosis.
Methods: The blood flow in the portal vein and existence of portosystemic shunt were studied in 52 and 27 patients with alcoholic and viral cirrhosis, respectively, by Doppler ultrasonography. The parameters of liver function test and the prevalence of ascites and esophageal varices were compared between patients with and without reversal blood flow.
Results: Reversal blood flow at the portal vein was found only in patients with only alcoholic cirrhosis (17 of 52 patients) but not in any patients with viral cirrhosis (0 of 27 patients; p < 0.05). The incidence of portosystemic ascites and red color of esophageal varices was also higher in patients with alcoholic cirrhosis with reversal blood flow in the portal vein compared with patients without reversal blood flow ( p < 0.05).
Conclusions: Reversal blood flow in the portal vein is a characteristic feature of alcoholic cirrhosis. The presence of reversal blood flow indicates severe liver diseases, and this feature may have prognostic importance for patients with alcoholic cirrhosis.     

Portal hypertensive colopathy in patients with liver cirrhosis

AIM: In patients with liver cirrhosis and portal hypertension, portal hypertensive colopathy is thought to be an important cause of lower gastrointestinal hemorrhage. In this study, we evaluated the prevalence of colonic mucosal changes in patients with liver cirrhosis and its clinical significance. METHODS: We evaluated the colonoscopic findings and liver function of 47 patients with liver cirrhosis over a 6-year period. The main cause of liver cirrhosis was post-viral hepatitis (68%) related to hepatitis B (6%) or C (62%) infection. All patients underwent upper gastrointestinal endoscopy to examine the presence of esophageal varices, cardiac varices, and congestive gastropathy, as well as a full colonoscopy to observe changes in colonic mucosa. Portal hypertensive colopathy was defined endoscopically in patients with vascular ectasia, redness, and blue vein. Vascular ectasia was classified into two types: type 1, solitary vascular ectasia; and type 2, diffuse vascular ectasia. RESULTS: Overall portal hypertensive colopathy was present in 31 patients (66%), including solitary vascular ectasia in 17 patients (36%), diffuse vascular ectasia in 20 patients (42%), redness in 10 patients (21%) and blue vein in 6 patients (12%). As the Child-Pugh class increased in severity, the prevalence of portal hypertensive colopathy rose. Child-Pugh class B and C were significantly associated with portal hypertensive colopathy. Portal hypertensive gastropathy, esophageal varices, ascites and hepatocellular carcinoma were not related to occurrence of portal hypertensive colopathy. Platelet count was significantly associated with portal hypertensive colopathy, but prothrombin time, serum albumin level, total bilirubin level and serum ALT level were not related to occurrence of portal hypertensive colopathy. CONCLUSION: As the Child-Pugh class worsens and platelet count decreases, the prevalence of portal hypertensive colopathy increases in patients with liver cirrhosis. A colonoscopic examination in patients with liver cirrhosis is indicated, especially those with worsening Child-Pugh class and/or decreasing platelet count, to prevent complications such as lower gastrointestinal bleeding.     

肝硬化患者心功能改变及其与肝功能的关系

目的研究肝硬化患者的心脏结构和功能变化,探讨其与肝功能的关系。方法 35例肝硬化患者按照肝功能Child-Pugh分级,A级12例（A组）,B级13例（B组）,C级10例（C组）。20例健康体检者为对照组。利用超声心动图测量静息状态下左室射血分数（EF）、左室直径（Vd）、左房直径（LAs）、右室直径（RVd）、E/A比值、室间隔厚度（IVS）、左室后壁厚度（LVPW）、主动脉瓣环直径（AAO）等指标。结果肝硬化组LAs大于对照组（P=0.000）,A组与B组间比较差异无统计学意义（P=0.248）,A组与C组比较,A组LAs小于C组（P=0.039）,B组与C组比较,B组LAs小于C组（P=0.008）。肝硬化组AAO大于对照组（P=0.000）;IVS肝硬化组大于对照组（P=0.026）;E/A值肝硬化组小于对照组（P=0.002）。结论肝硬化患者存在左心功能不全,以舒张功能不全为主,并与肝功能具有一定关系,提示肝硬化心肌病的存在。当肝硬化患者行心脏二维多普勒超声出现LAs增大、E/A〈1时需注意肝硬化心肌病的可能。     

Relationship of portal hypertension to ascites in Laennec''s cirrhosis

The effect of portacaval anastomosis on the fluid and electrolyte balance of five selected patients with Laennec's cirrhosis and chronic ascites was studied. In these persons ascites disappeared following the shunt operation, although marked peripheral edema developed in several cases. These observations are presented in support of the importance of the role of portal hypertension in the formation of ascites in Laennec's cirrhosis.

Portacaval anastomosis is not advocated as a general method of treating chronic ascites, although it may be beneficial in some patients.

In two additional patients cited ascites made its first appearance shortly after portacaval anastomosis was established. A possible mechanism is postulated.

The formation of ascitic fluid in experimental animals in whom hepatic venous pressure is elevated is also discussed. It is considered that these results apply to the formation of ascites in certain clinical conditions but do not necessarily apply in the case of Laennec's cirrhosis.     

肝硬化患者血浆降钙素基因相关肽及内皮素-1水平的变化

目的 探讨肝硬化患者血浆降钙素基因相关肽（ＣＧＲＰ）及内皮素－１（ＥＴ－１）水平的变化,了解此二者之间及它们与肝硬化门脉高压形成及局长和肝功能损伤的关系。方法 用放免法检测２４例正常人和６１例肝硬化患者血浆ＣＧＲＰ和ＥＴ－１水平。结果 肝硬化组血浆ＣＧＲＰ及ＥＴ－１水平显著高于对照组,且在肝功能分级中,呈现ＣｈｉｌｄＣ〉Ｃｈｉｌｄ Ｂ〉ＣｈｉｌｄＡ的规律。组间分析表明肝硬化患者食管静脉曲张伴大中量     

利水软肝汤、中药敷脐联合温针灸对肝硬化腹水患者肝功能、尿量和门静脉血流动力学的影响

目的:观察利水软肝汤、中药敷脐联合温针灸对乙型肝炎肝硬化腹水患者肝功能、尿量和门静脉系统血流动力学的影响。方法:选取2016年1月至2019年12月104例乙型肝炎肝硬化腹水患者进行研究,随机分为观察组和对照组,每组52例。对照组患者采用西医常规治疗。观察组患者在对照组治疗的基础上采用利水软肝汤、中药敷脐联合温针灸治疗。比较两组患者治疗后的总有效率、治疗前后腹围、体重、肝功能、24 h尿量、腹水暗区深度、门静脉系统血液动力学的变化。结果:治疗1个月后,观察组患者总有效率高于对照组,差异有统计学意义(P<0.05);观察组患者肝功能和门静脉系统血液动力学改善程度优于对照组,差异有统计学意义(P<0.05)。观察组患者腹围、体重和腹水暗区深度低于对照组;观察组24 h尿量高于对照组,差异有统计学意义(P<0.05)。结论:利水软肝汤、中药敷脐联合温针灸治疗乙型肝炎肝硬化腹水患者的疗效较好,能明显改善患者肝功能,降低腹水量、增加24 h尿量,进而降低腹围、体重,明显改善门静脉系统的血流动力学。     

Value of portal hemodynamics and hypersplenism in cirrhosis staging

AIM: To determine the correlation between portal hemodynamics and spleen function among different grades of cirrhosis and verify its significance in cirrhosis staging. METHODS: The portal and splenic vein hemodynamics and spleen size were investigated by ultrasonography in consecutive 38 cirrhotic patients with cirrhosis (Child's grades A to C) and 20 normal controls. The differences were compared in portal vein diameter and flow velocity between patients with and without ascites and between patients with mild and severe esophageal varices. The correlation between peripheral blood cell counts and Child's grades was also determined. RESULTS: The portal flow velocity and volume were significantly lower in patients with Child's C (12.25±1.67 cm/s vs 788.59±234 mm/min, respectively) cirrhosis compared to controls (19.55±3.28 cm/s vs 1254.03±410 mm/min, respectively) and those with Child's A (18.5±3.02 cm/s vs 1358.48±384 mm/min, respectively) and Child's B (16.0±3.89 cm/s vs 1142.23±390 mm/min, respectively) cirrhosis. Patients with ascites had much lower portal flow velocity and volume (13.0±1.72 cm/s vs1078±533 mm/min) than those without ascites (18.6±2.60 cm/s vs1394±354 mm/min). There was no statistical difference between patients with mild and severe esophageal varices. The portal vein diameter was not significantly different among the above groups. There were significant differences in splenic vein diameter, flow velocity and white blood cell count, but not in spleen size, red blood cell and platelet counts among the various grades of cirrhosis. The spleen size was negatively correlated with red blood cell and platelet counts (r= -0.620 and r= -0.8.34, respectively). CONCLUSION: An optimal system that includes parameters representing the portal hemodynamics and spleen function should be proposed for cirrhosis staging.     

肝硬化患者胰岛素抵抗与肌钙蛋白Ⅰ的关系

目的 研究肝硬化患者胰岛素抵抗与肌钙蛋白Ⅰ的关系。方法 用发光免疫法测定空腹胰岛素(FINS)及肌钙蛋白Ⅰ(TnI),用1/(FINS×FPG)的自然对数作为胰岛素敏感指数(ISI),对ISI与TnI进行相关分析。结果 肝硬化患者ISI明显低于对照组,肝硬化患者TnI明显高于对照组,硬化患者的ISI与TnI呈负相关关系。结论 肝硬化患者的胰岛素抵抗与心肌损害存在一定内在联系。