【摘要】 目的:观察肝硬化患者血流动力学变化情况及血浆内毒素(LPS)、肿瘤坏死因子-α(TNF-α)和NO的水平并探讨之间相关关系。方法:试验检测血浆内毒素,双抗体夹心ELISA检测TNF-α,NO2-/NO3-测定采用硝酸还原法,并对CO、MAP、SVRI行同步观察。结果:健康组与肝硬化患者比较,失代偿组高动力循环状态特征明显。失代偿组、代偿组、健康组LPS、TNF-α、NO依次明显升高(P<0．01)。血浆LPS与TNF-α和NO之间呈直线正相关。血浆NO水平与CO呈显著性正相关;与MAP、SVRI呈显著性负相关。结论:肝硬化患者血浆LPS、TNF-α、NO生成增多,NO在肝硬化血液动力学紊乱中起重要作用。更多还原

【Abstract】 Objective: To study the hemodynamics state and the plasma levels of nitrous oxide (NO), tumor necrosis factor-α(TNF-α) and Endotoxin (LPS) and their relationship. Methods: Cardiac output (CO), systemic vascular resistance index (SVRI) and mean arterial pressure (MAP) were measured; plasma endotoxin was observed using the Limulus test; plasma TNF-αwas determined by the ABC-enzyme-linked immunosorbent assay; the plasma level of NO was detected using nitric reductase. Results: The characteristic of hyperkinetic state of circulation was obvious in the decompensated cirrhotic patients. Plasma endotoxin, TNF-αand NO levels were higher in decompensated cirrhotic patients than those in compensated cirrhotic patients, which were the highest in normal controls. There are positive correlations among LPS, TNF-αand NO in cirrhotic patients. The level of NO had a positive correlation with CO and had a negative correlation with MAP and SVRI. Conclusions: Hyperkinetic circulation in cirrhosis is more obvious in those with more severe liver dysfunction. NO might play an important role in hemodynamics dysfunction.更多还原