【作者】 吴斌；

【导师】 许戈良； 黄强；

【作者基本信息】 安徽医科大学 ， 外科学， 2003， 硕士

【摘要】 目的 通过比较研究肝硬化食管静脉曲张出血组、肝硬化无出血组和健康对照组血浆一氧化氮(NO)、内皮素(ET)水平以及血浆NO、ET水平与门静脉直径(PVD)、脾静脉直径(SVD)、门脉右支血流速度(RPBV)、食管静脉直径(EVD)和食管粘膜红色征(“R-C”征)的关系，探讨血浆NO、ET水平和肝硬化食管静脉曲张出血的相关性。方法 选择14例肝硬化出血病人，15例肝硬化无出血病人，并选择15名健康献血员作对照，用比色法分别测取血浆NO水平，用放免法测取血浆ET水平，并对三组人员用彩色多普勒分别测取PVD、SVD和RPBV，用胃镜测量两组肝硬化忠者EVD并观察记录食管粘膜“R-C”征，比较各组间血浆NO、ET水平的变化，综合分析NO和ET之间，NO、ET水平和PVD、SVD、RPBV、EVD、“R-C”征之间的相互关系，并用SPSS V 10.0 for Windows作统计学分析。结果 肝硬化出血组和非出血组的血浆NO、ET水平均明显高于正常对照组(p＜0.01)，肝硬化出血组血浆NO、ET水平明显高于非出血组(p＜0.01)，血浆NO、ET水平之间以及分别和PVD、SVD和EVD为直线正相关(p＜0.01或p＜0.05)，和RPBV为直线负相关(p＜0.01)，PVD＞1.3cm组的血浆NO、ET水平明显高于p≤1.3cm组(p＜0.01)，EVD＞5mm组的血浆NO、ET水平明显高于p≤5mm组(p＜0.01)，“R-C”征组血浆NO、ET水平明显高于无“R-C”征组。结论 血浆NO、ET水平和肝硬化食管静脉曲张出血之间存在相关关系，可以作为评估肝硬化食管静脉曲张出血有价值的二项指标。更多还原

【Abstract】 Objective To study the relationship between the plasma NO and ET levels of and esophagus varicosity hemorrhage in cirrhosis patients and to investigate the possibility of estimating hemorrhage by measuring the plasma NO and ET levels. Methods Fourteen cirrhotic patients with esophageal varicosity hemorrhage, 15 cirrhotic patients without hemorrhage and 15 healthy controls were recruited. The plasma NO level was examined by the calorimetric assay, and the plasma ET level by the radio immunoassay (RIA). Portal vessel diameter (PVD), Spleen vessel diameter (SVD) and right portal blood velocity (RPBV) were measured by the Color Doppler. Esophagus vessel diameter (EVD) and red color ( "R-C" ) symptom were determined by the endoscope. The levels of NO and ET were compared among these three groups. The relationships among NO and ET levels and PVD, SVD, RPBV, EVD and R-C signs were evaluated. Results Compared to the normal controls, the plasma NO and ET levels were significantly higher in cirrhotic patients with hemorrhage than those without hemorrhage (p<0.01). There was a significant and positive correlation between the plasma NO and ET levels, as well as among the levels of NO, ET and PVD, SVD and EVD (p<0.05-p<0.01). A significantly negative correlation was observed among the plasma levels of NO, ET and RPBV (p<0.01). The levels of NO and ET were significantly higher in patients with PVD> 1.3cm than those with PVD 1.3cm (p< 0.01), in patients with EVD>mm than those with EVD 5mm (p<0.01), and in patients with "R-C" signs than those without "R-C" signs (p<0.01), respectively. Conclusion There may exist an association between the plasma levels of NO, ET and esophageal varicosity hemorrhage in patients with cirrhosis, suggesting that the plasmalevels of NO and ET may be predicative parameters for esophageal varicosity hemorrhage in cirrhotic patients.更多还原