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目的 探讨血浆内皮素 - 1(ET - 1)水平的变化 ,了解它与肝硬化门脉高压形成发展和肝功能损伤的关系。方法 用放免法检测 2 4例正常人和 6 1例肝硬化患者血浆ET - 1。结果 肝硬化组血浆ET - 1水平显著高于对照组 (P均 <0 0 0 1) ,且在肝功能分级中 ,呈现ChildC >ChildB >ChildA的规律。组间分析表明肝硬化患者食道静脉曲张伴大中量腹水组 (LC4)血浆ET - 1显著高于大中量腹水组 (LC3 ) ,LC3 组高于食道静脉曲张伴少量腹水或无腹水组 (LC2 ) ,LC2 组高于无腹水和静脉曲张组 (LC1) (P均 <0 0 5 )。LC1组及ChildA级患者与对照组间无明显差别 (P >0 0 5 )。相关分析显示肝硬化者血浆ET - 1与白蛋白水平间呈明显负相关 ,与sGOT、总胆红素间呈显著正相关。结论 肝硬化者血浆ET - 1水平反映了肝硬化的严重程度 ,并在门脉高压的形成发展中起重要作用。
Objective To investigate the changes of endothelin - 1 (ET - 1) in plasma and its relationship with the development of cirrhosis and portal hypertension. Methods Twenty - four normal subjects and 61 patients with cirrhosis were tested for plasma ET - 1 by radioimmunoassay. Results The level of ET - 1 in cirrhosis group was significantly higher than that in control group (all P <0 01). And in the classification of liver function, the pattern of ChildC> Child B> Child A was presented. Intergroup analysis showed that the ET - 1 level in patients with cirrhosis and esophageal varices with large amount of ascites group (LC4) was significantly higher than that of LC3 group (LC3). LC3 group was higher than esophageal varices with a little ascites group or without ascites group LC2), LC2 group was higher than ascites and varicose vein group (LC1) (P <0.05). There was no significant difference between LC1 group and ChildA class and control group (P> 0.05). Correlation analysis showed that there was a significant negative correlation between ET - 1 and albumin levels in cirrhotic patients, and a significant positive correlation with sGOT and total bilirubin. Conclusion The plasma level of ET - 1 in cirrhotic patients reflects the severity of liver cirrhosis and plays an important role in the formation and development of portal hypertension.