肝硬化门静脉高压症患者血浆中ET-1、CGRP与腹水及肝功能的相关性

Correlations of plasma levels of ET-1 and CGRP with ascites and liver function in cirrhosis patients with portal hypertension

摘要:

目的：探讨肝硬化门静脉高压症患者门静脉血及外周静脉血中内皮素-1（Endothelin，ET-1）及降钙素基因相关肽（Calcitonin gene-related pepfide，CGRP）与腹水及肝功能的相关性。方法：检测78例肝硬化门静脉高压症患者门静脉血及外周静脉血中ET-1及CGPR的浓度。78例肝硬化门静脉高压症患者中，有腹水42例，无腹水36例；child-pugh肝功能分级，A级35例，B级26例，C级17例。对照组20例。结果：门静脉高压症患者无腹水组门静脉血和外周静脉血中ET-1浓度与对照组比较，差异有统计学意义（P<0.05），有腹水组门静脉血和外周静脉血中ET-1浓度与无腹水组比较，差异有统计学意义（P<0.05）。在有腹水组，门静脉血ET-1浓度与外周静脉血ET-1浓度比较，差异有统计学意义（P<0.05）。有腹水组门静脉血及外周静脉血中CGRP浓度与无腹水组比较，差异有统计学意义（P<0.05）。B级肝功能组门静脉血和外周静脉血中ET-1、CGRP浓度与A级肝功能组比较，差异有统计学意义（P<0.05），C级肝功能组门静脉血中ET-1浓度与外周静脉血中ET-1浓度比较，差异有统计学意义（P<0.05）。C级肝功能门静脉血和外周静脉血中CGRP浓度与B级肝功能组比较，差异有统计学意义（P<0.05）。肝功能状态与门静脉血及外周静脉血中ET-1浓度均呈显著负相关（rs=-0.783，P<0.05；rs=-0.695，P<0.05）；与门静脉血及外周静脉血中CGRP浓度也呈显著负相关（rs=-0.642，P<0.01；rs=-0.671，P<0.05）。结论：肝硬化门静脉高压症患者，门静脉血及外周静脉血中ET-1和CGRP升高与腹水形成有关，肝功能状态与门静脉血及外周静脉血中ET-1和CGRP具有相关性，血浆中ET-1、CGRP浓度可以作为反映患者肝功能状态的指标。

Abstract:

Objective：To analyze the correlations of plasma levels of endothelin-1（ET-1）and calcitonin gene-related pepfide（CGRP） with ascites and liver function in cirrhosis patients with portal hypertension. Methods：Seventy eight cirrhosis patients with portal hy－pertension were enrolled in this study and the plasma levels of ET-1 and CGRP in the peripheral venous blood and portal venous blood of all patients were detected. Among the 78 patients，42 with ascites and 36 without ascites. Based on child-pugh classification，35 cases were in class A，26 cases were in class B and 17 cases were in class C. Results：There were significant differences in ve－nous blood ET-1 levels between portal hypertension patients without ascites and the control patients（P<0.05）. Significant differences in venous blood ET-1 levels between patients with ascites and patients without ascites were observed（P<0.05）. In patients with ascites，there were significant differences in ET-1 levels between portal vein blood and peripheral venous blood（P<0.05）. Significant differ－ences in venous blood levels of CGRP between patients with ascites and patients without ascites were observed（P<0.05）. There were statistical differences in levels of ET-1 and CGRP in the peripheral venous blood and portal venous blood between class A patients and class B patients（P<0.05）. There were statistical differences between levels of EF-1 in portal venous blood and levels of ET-1 in peripheral venous blood in class C patients（P<0.05）. There were statistical differences between levels of CGRP in peripheral ve－nous blood and levels of CGRP in portal venous blood in class C patients（P<0.05）. Furthermore，the liver function was negatively cor－related with level of ET-1 and CGRP in the peripheral venous blood and portal venous blood（rs=-0.783，P<0.05；rs=-0.695，P<0.05）（rs=-0.642，P<0.05，rs=-0.671，P<0.05）. Conclusions：The high level of venous blood ET-1 and CGRP is correlated with as－cites formation in cirrhosis patients with portal hypertension. Moreover，the liver function is also correlated with venous blood levels of ET-1 and CGRP，which indicates that venous blood levels of ET-1 and CGRP might be potent hypertensive indica－tors of liver function in cirrhosis patients.