病毒性肝炎患者血浆神经肽的变化及其临床意义

目的：探讨病毒性肝炎患者血浆神经肽的变化规律及其意义。方法：用放射免疫法(RIA)检测了67例各型肝炎患者及10名正常人血浆亮啡肽、神经肽Y含量。结果：各型肝炎患者急性肝炎、慢重肝、慢肝重度和中度血浆亮啡肽含量显著高于正常对照组(P<0.05)，且慢重肝和慢肝重度显著高于其他各组(P<0.01)。神经肽Y显著低于慢肝轻度和正常对照组(P<0.01)。在慢性肝病者中，血浆亮啡肽与血清总胆红素呈正相关，与清蛋白和凝血酶原活动度呈负相关，而神经肽Y与之相反。结论：病毒性肝炎患者血浆亮啡肽显著升高，而神经肽Y显著降低，并与肝损害程度基本一致。推测该两种神经肽可能参与了病毒性肝炎的病理损害过程，并与某些临床症状有关，可作为评价肝功能的一项辅助指标。

Study on the levels of plasma leucineenkephalin and neuropeptide Y in patients with viral hepatitis

Objective: To assess the clinical significance of plasma neuropeptides in patients with viral hepatitis. Methods: Levels of plasma leucinenkephalin (LENK) and neuropeptide Y (NPY) were detected with radioimmunoassay in 67 patients with hepatitis and 10 healthy controls. Results: The level of LENK in patients was significantly higher than that in controls ( P <0.05). In patients with hepatitis, the level of LENK was higher in chronic hepatic failure and chronic hepatitis (severe) than that in the rest ( P <0.01). The concentration of LENK was positively correlative with serum total bilirubin (TBIL) ( r =0.43, P < 0 01 ), but negatively correlative with serum albumin (ALB) ( r =-0.25, P <0.05) and prothrombin time activity (PA) ( r =-0.55, P <0.01). The levels of NPY in chronic hepatic failure and chronic hepatitis (severe and medium) were significantly lower than that in other viral hepatitis groups and healthy controls ( P <0.01). The concentration of plasma NPY in chronic hepatitis was negatively correlated with TBIL ( r =-0 34, P <0.01), but postively correlated with ALB and PA (each r =0.38, P <0.01). Conclusion: Plasma LENK and NPY levels may be used as an associated marker for judging liver function. They may contribute to the pathogenesis of viral hepatitis and some of its symptoms.