肝性脑病患者血清褪黑素变化及其诊断价值

目的研究肝性脑病患者血清褪黑素（Melatonin，MT）变化及其诊断价值。方法用酶联法测定伴有肝性脑病肝硬化组和无肝性脑病肝硬化组凌晨4时血清MT，取正常参照组做比较。并动态测定肝性脑病发病期和恢复期的血清MT浓度。结果肝性脑病组血清MT比单纯肝硬化组高，两组均比正常参照组高。分别为(312.7±77.4)ng/L、（149.8±238.3）ng/L、（77.7±28.4）ng/L。肝性脑病发病期比恢复期高，分别为（308.5±59.1）ng/L和（147.8±37.2）ng/L。血清MT＞220ng/L，对肝性脑病诊断敏感性为79%，漏诊率为21%。结论血清MT水平升高可能是肝性脑病发生的机制之一，动态测定血清MT对于诊断肝性脑病有参考价值。

The change of serum melatonin and diagnosis value in hepatic encephalopathy

OBJECTIVE: To explore the change of serum melatonin (MT) and its diagnosis value in hepatic encephalopathy (HE). METHODS: The change of MT in serum in cirrhotic patients with HE and without HE was determined by ELISA, and normal serum served as control. The change of serum MT during exacerbation and remission stage of HE was also determined. RESULTS: The level of MT in patients with HE was higher than that without (P<0.01). Both groups were higher than normal group (312.7 +/- 77.4) ng/L, (149.8 +/- 38.4) ng/L, and (77.3 +/- 28.4)ng/L, respectively, P<0.01. The level of serum MT was higher in exacerbation stage than remission stage, (308.5 +/- 59.1) ng/L and (147.8 +/- 23.3) ng/L, respectively, P<0.01. CONCLUSION: The elevation of MT in serum may be one of pathogenic factors for HE. Dynamic measurement of MT in serum is conducive to the diagnosis of HE.