肝硬化患者血浆内皮素和胰高血糖素水平的变化及其临床意义

目的 研究肝硬化时血浆内皮素-1(ET-1)和胰高血糖素(GLU)水平的改变及其与肝功能损害和门脉高压形成的关系。方法 采用放射免疫分析法测定40例肝硬化患者和18例对照组空腹血浆ET-1和GLU水平。用彩色多普勒超声测定门静脉及脾静脉的直径、流速和流量。结果 肝硬化患者血浆ET-1和GLU水平显著高于对照组。按肝功能Child-Pugh分级将肝硬化患者分为A、B、C三组，各组血浆ET-1和GLU水平依次升高。合并腹水的肝硬化患者血浆ET-1和GLU水平显著高于未合并腹水者。血浆ET-1和GLU水平与门静脉和脾静脉的直径以及脾静脉的流量呈显著正相关。结论 肝硬化患者血浆ET-1及GIU水平升高反映了肝功能损害的严重程度，同时在门静脉高压的形成和发展过程中起着重要的作用。

Changes of plasma levels of ET-1 and glucagon in cirrhotic patients and its clinical value

Objective To investigate the changes of plasma levels of endothelin(ET-1)and glucagon(GLU)in cirrhotic patients and its effect in the pathogenesis of portal hypertension.Methods Plasma levels of ET-1 and GLU were measured by radioimmunoassay(RIA)in 40 patients with liver cirrhosis and 18 healthy controls.The max diameters,mean flow velocity,flow rate of the portal vein trunks(PV)and splenic veins(SV)were detected by Color Doppler Ultrasound.Results Plasma levels of ET-1 and GLU in cirrhotic patients were significantly higher than those in controls and were increased with the severity of hepatic function impairment as assessed by Child-Pugh grade.Patients with ascites showed significant higher plasma ET-1 and GLU levels than those without ascites.Plasma levels of ET-1 and GLU were positively correlated with portal vein diameters,splenic vein diameters and splenic vein flows.Conclusion The increase of plasma ET-1 and GLU levels reflects,in part,the severity of impairment of hepatic function.In addition,it may contribute to the pathogenesis of portal hypertension.