男性肝硬变"三联征"的病机探讨

目的：探讨男性肝硬变伴“三联征”（肝掌、蜘蛛痣、乳房发育）患者血清一氧化氮（NO）、雌二醇（E2）水平的变化及其与“三联征”的关系、有关机理和临床意义。方法：Griess试剂检测64例男性肝硬变（按Child-Pugh分为A组和B、C组）及36例年龄匹配男性健康体检者血清NO水平，放射免疫法检测E2水平。结果：血清NO在肝硬变各组明显高于对照组（P＜0．05），B、C组明显高于A级组（P＜0．01）B、C级组明显高于A级组和对照组，A级组与对照组之间也有显著差异。血清E2在B、C级组和A级组明显低于对照组（P＜0．01，P＜0．05）B、C级组与A级组无显著差异。（P＞0．05）。结论：男性肝硬变伴“三联征”患者血清E2水平下降，NO水平升高。男性肝硬变“三联征”并不一定是由于雌激素水平升高引起的，而有可能是升高的NO使小动脉末梢的毛细血管扩张所致。

Discussion on the pathogenesis of trilogy in male patients with liver cirrhosis

Objective To explore the levels of nitric oxide(NO) and estradiol(E 2) in serum of male liver cirrhosis patients with trilogy(liver palms,vascular spider,mammary development) and the relationships between them and trilogy as well as its mechanism and clinical significance.Methods NO and E 2 were inspected by Griess reagent and radioimmunity,respectively,in serum of 64 male patients with liver cirrhosis(including A stage and B,C stage according to Child Pugh) and 36 healthy men with the opproximate age.Results The NO level was significantly higher in B and C stage group than that in A stage group and control group,with no significant difference between A stage group and control group.The E 2 level was significantly lower in liver cirrhosis group than that in control group,with no significant difference between B,C stage group and A stage group.Conclusion E 2 level is lowered and NO is improved in serum of male trilogy patients with liver cirrhosis.Trilogy is not caused only by improved estrin level,but improved NO can cause trilogy by dilating capillary of the end of small artery.