一氧化氮、内皮素在胆道梗阻病程中的变化及意义

目的 了解NO、ET1等在胆石性胆道梗阻病程演进过程中的作用及其临床意义。方法 对胆石性胆道梗阻患者，按黄疸发生时间、血内毒素检测结查、有无急性胆管炎分组比较NO、ET内毒素和肝功能变化关系。结果 梗阻性黄疸I、Ⅱ组NO与ET1呈负相关；Ⅲ组NO与ET1呈负相关。内毒素阳性组、有胆管炎组：NO ET1无相关关系。结论 ①胆道感染、内毒素等导致NO与ET1的协调关系紊乱、NO的正常保护机制受损，这在胆道梗阻所致肝功能衰竭、肝纤维化等发病机制中可能起了重要作用。②检测比较NO／ET的变化关系，可能作为了解肝细胞损害程度、肝储备功能的参考指标。

CHANGE AND IT'S SIGNIFICANCE OF SERUM NITRIC OXIDE AND ENDOTHELIN-1 L EVEL IN PATIENTS WITH OBSTRUCTION JAUNDICE

Objective To understand the clinical significance of serum level changement of nitric oxide and endothelin 1 in course of obstruction jaundice caused by cholelithiasis.Methods Those patients with obstruction jaundice caused by cholelithiasis were divided into three groups,according to the last time of jaundice,checkout of blood endotoxin result,with or without the acute cholangitis.comparison was made in serum albumin,globulin,bilirubin,ALT and NO,ET 1 and endotoxin between groups.Results In cases with jaundice ,a negative correlation between NO and ET 1 was found in group 1 and 2.But there was not a negative correlation in group3.A negative correlation between NO and ET 1 was also found in these groups without endotoxemia and without the acute cholangitis.But there were not a negative correlation in groups with endotoxemia and with the acute cholangitis.Conclusion 1. Bacterium,infection and endotoxmia leads to the imbalance of NO/ET 1 damage to normal NO protection mechanism, which has possibly played the important role in pathogenesis of liver function failure and liver fibrosis etc.2. it may reflect the liver cell function and the liver damage degree to examine the serum NO/ET level and compare their relation.