肝纤维化患者血流动力学改变与ET-1、NO的关系

目的:探讨肝纤维化患者内皮素-1(ET-1)和一氧化氮(NO)含量与肝脏血流动力学改变的关系。方法:运用彩色多普勒超声对60例经临床、实验室、病理组织学检查确诊为肝纤维化患者进行检查,测量肝脏血流动力学指标,同时检测ET-1和NO浓度,分析血管活性物质与肝脏血流动力学指标变化间的关系。结果:肝纤维化初期门静脉、脾静脉及肠系膜上静脉内径、血流速度、血流量与对照组无显著差异,但在S3、S4期门静脉、脾静脉及肠系膜上静脉内径增宽,血流速度下降,血流量增加,尤其以脾静脉血流量增加显著,与对照组比较有显著差异(P<0.01);血清NO、ET-1的含量均高于正常对照组(P<0.05),且以ET-1/NO比值增加更为明显。结论:彩色多普勒超声可无创检测肝脏血流动力学变化,血清NO、ET-1含量与肝纤维化的程度有良好的相关性,对肝纤维化的诊断及疗效观察有一定临床应用价值。

Relationship between Hemodynamic Change and Endothelin-1, Nitric Oxide in Patients with Liver Fibrosis

Objective To explore the relationship between hemodynamic change and the contents of endothlin-1(ET-1),nitric oxide(NO) in patients with liver fibrosis.Methods Color doppler ultrasound was performed in 60 liver fibrosis patients confirmed by clinical manifestation,laboratory test and pathohistology,the indexes of liver hemodynamics were recorded,the contents of ET-1 and NO were determined correspondingly,then the relationship between vasoactive substance and liver hemodynamic change was analyzed.Results In early liver fibrosis patients,the internal diameters of portal vein(PV),splenic vein(SV) and superior mesenteric vein(SMV),the velocity and volume of blood flow had no significant difference with control group;while in S 3,S 4 stages patients,the internal diameters of PV,SV,SMV were widenen,the velocity of blood flow was decreased,the volume was increased especially in splenic vein,and all the changes had significant difference with control group(P <0.01);the serum contents of NO,ET-1 were significantly higher than that of normal control(P <0.05),the ratio of ET-1/NO was increased obviously.Conclusion Color doppler ultrasound could be a noninvasive detective method for liver hemodynamic changes,the degree of liver fibrosis may correlate with the serum contents of ET-1 and NO,which may be useful for clinical diagnosis and treament in patients with liver fribrosis.