肝硬变腹水患者门腔静脉分流术后肾素活性、血管紧张素转换酶及血管紧张素Ⅱ的变化

目的探讨肝硬变腹水患者行门腔静脉分流术前后肾素活性（ＰＲＡ）、血管紧张素转换酶（ＡＣＥ）、血管紧张素Ⅱ（ＡⅡ）水平及门静脉压力（ＰＶＰ）的变化。方法应用光度比色分析和放射免疫分析法，对１６例肝硬变合并腹水的患者行门腔静脉分流术前后和１６例行胃肠道肿瘤切除手术的对照组患者，手前后的门静脉、外周静脉和动脉血中的ＰＲＡ、ＡＣＥ、ＡⅡ及ＰＶＰ进行了测定。结果肝硬变组门腔静脉分流前后的ＰＲＡ、ＡＣＥ、ＡⅡ及ＰＶＰ显著高于对照组（Ｐ＜００５），分流后的ＰＲＡ、ＡＣＥ、ＡⅡ及ＰＶＰ水平较分流前显著降低（Ｐ＜００５），肝硬变腹水患者血中ＡＣＥ水平与ＰＶＰ呈明显正相关（Ｐ＜００１）。结论门腔静脉分流术能有效的降低肝硬变腹水患者的ＰＶＰ和ＰＲＡ、ＡＣＥ、ＡⅡ水平，这是导致肝硬变腹水患者术后腹水消失的重要原因。

The levels of rinin activity, angiotensin coverting enzyme and angiotensin in cirrhotic patients with ascites undergoing portacaval shunt

Objective To investigate the changes of plasma rinin activity (PRA),angiotensin coverting enzyme (ACE), angiotensin and portal venous pressure (PVP)in cirrhotic patients with ascites undergoing portacaval shunt. Methods Serum PRA,ACE, A levels in portal vein, artery,peripheral vein and PVP were measured in 16 cirrhotic patients with ascites before and after portacaval shunts and in contral group of 16 casese of gastrointestinal carcinoma. By light colorimetric analysis and radioimmunization assay. Results PRA,ACE,A levels and PVP of pre and after portacaval shunt were significantly higher in cirrhotic patients than the control group (P<005) ,and they were significantly decreased after the shunt in the cirrhotic patients (P<005). The PVP was in positive correlation to the levels of serum ACE in cirrhotic patients (r=048, P<001). ConclusionsZThe levels of serum PRA,ACE,Aand PVP decreased significantly in cirrhotic patients with portal hypertension after portacaval shunts.It may be major causes of ascites disappearence in cirrhotic patients after portacaval shunt.