【摘要】 目的:探讨内皮素(endothelin,ET)在门静脉高压症断流术后门静脉血栓形成(portal vein thrombosis,PVT)中的术前预测价值。方法:接受脾切除加贲门周围血管离断手术的48例门静脉高压症患者分为术后血栓组(简称血栓组,15例)与术后非血栓组(简称无血栓组,33例)。术前外周血中检测血小板(platelet,PLT)数,凝血4项;术前1 d及术后7 d分别检测外周血ET含量;术前彩色多普勒超声检测门静脉直径、脾静脉直径、门静脉平均血流速度,术后7 d、14 d复查彩超,了解有无门静脉血栓,并分别对两组患者的上述指标进行统计学对比分析。结果:血栓组术前1 d外周静脉血中的ET水平明显高于非血栓组[(144.45±20.32)pg/mL vs(102.51±16.43)pg/mL;P<0.05],且术后第7 d其外周血中的ET检测水平高于后者[(87.68±7.53)pg/mL VS(70.46±6.71)pg/mL;P<0.05]。血栓组患者的门静脉直径及脾静脉直径均比无血栓组患者大,而门静脉平均血流速度则比后者慢,两者的差异存在统计学差异(P<0.05)。两组患者术前PLT及凝血4项检测,两者之间比较没有统计学差异(P>0.05)。结论:血浆ET可作为断流术后PVT发生的术前预测因子。更多还原

【Abstract】 Aim: To explore the predictive value of endothelin(ET) for predicting portal vein thrombosis(PVT) after pericardial devascularization.Methods: Clinical data of 48 cases of portal hypertension received pericardial devascularization were divided into two groups: PVT group(n=15) and non-PVT group(n=33).Alterations on the platelet(PLT) count and the indices of coagulation were detected peri-operatively in the patients,and the levels of endothelin were detected by using enzyme linked immunosorbent assay(ELISA) method pre-and post-operatively in the patients.The diameter and blood stream speed of the portal vein(PV) and the spleen vein(SV) were measured by the color doppler uhrasonograph.Above indices were analyzed with statistics.Results: The levels of endothelin pre-and post-operatively in the patients in PVT group were larger than that in non-PVT group(144.45±20.32) ρg/mL vs(102.51±16.43) pg/mL,(87.68±7.53) pg/mL VS(70.46±6.71) pg/mL;Both(P<0.05).The diameter of the portal vein and the spleen vein in the patients in PVT group were superior to that in non-PVT group(P<0.05),but The former blood stream speed of the portal vein was slower than the latter(P<0.05).The platelet count and the indices of coagulation in two groups did not show any significant difference(P<0.05).Conclusion:Serum ET levels is a the predictor to forecast the portal vein thrombosis risk after pericardial devascularization.更多还原