血浆内皮素与总胆红素含量检测在门脉高压大出血中的意义

【目的】探讨血浆内皮素(ET)和总胆红素(TBIL)含量在门脉高压症大出血时的动态变化及其临床意义。【方法】将61例肝硬化门脉高压症病人分为三组:对照组,出血组,死亡组。分别检测出三个组出血发生后不同时间血浆ET和血清TBIL含量变化情况。【结果】对照组ET含量(57.62±17.15)pg/ml,TBIL含量为(12.42±6.53)μmol/L,出血组ET(100.32±24.28)pg/ml,TBIL(37.20±28.87)μmol/l,出血组出血后d1、d2血浆ET浓度较对照组显著增高(P<0.01),随后于4～7d逐步下降。死亡组ET(124.86±20.7)pg/ml,呈显著增高,TBIL为(30.96±11.46)μmol/L。出血组、死亡组出血d1TBIL水平基本接近(P>0.05),d2TBIL显著升高(P<0.01)。【结论】过高的ET、TBIL水平可能提示肝功能损害和病人预后不良。动态检测ET、TBIL对于了解患者的病情,提高诊疗水平有重要的临床意义。

The Clinical Value of Detecting Endothelin and Total Bilirubin Levels in the Cirrhotic Patients of Portal Hypertension with Hematemesis

Objective]To observe the dynamic changes and investigate the clinical value of the plasma endothelin(ET) and total bilirubin(TBIL) levels in the cirrhotic patients of portal hypertension with hematemesis.Methods]Sixty-one cirrhotic patients with portal hypertension were divided into control group, hematemesis group and death group. The plasma ET and serum TBIL levels of all subjects were measured in the different times after hematemesis by radioimmunprecipitation method.Results]In comparsion with control group, the ET level was significantly higher in the 1st and 2nd day after the hematemesis( P <0.01).In the 4th and 7th day after treatment,the ET level was on the decline step by step. The ET and TBIL levels of death group were significantly higher, compared with control and hematemesis group( P <0.01).The TBIL levels of hematemesis group and of death group was basically unanimous( P >0.05).Conclusion]The excessively high ET and TBIL levels in the patients of portal hypertension with hematemesis may lead to bad prognosis.The dynamic observance of TBIL and ET level is helpful for understanding the patient's condition and improving diagnosis and treatment.