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目的探讨肝硬化门静脉高压症(LCPH)患者并发肝肺综合征(HPS)时血浆一氧化氮(NO)和内皮素1(ET-1)水平的变化及其意义。方法回顾分析52例LCPH患者临床资料。按有无并发HPS分为Ⅰ(并发HPS)组和Ⅱ(未并发HPS)组。应用硝酸还原酶法检测血浆NO水平,放免法检测血浆ET-1水平。结果HPS总发生率为11.5%(6/52),Child-Pugh C级发生率为30%(3/10)。Ⅰ组Child-Pugh C级的比例为50%(3/6),血浆NO水平达(110.40±28.02)μmol/L,明显高于Ⅱ组(P<0.01),而血浆ET-1水平两组间差异无统计学意义(P>0.05)。结论血浆NO水平升高是HPS发生的重要特征;提示联合肝功能Child-Pugh分级,对LCPH并发HPS有诊断意义。
Objective To investigate the changes of plasma levels of nitric oxide (NO) and endothelin-1 (ET-1) in patients with cirrhosis and portal hypertension (LCPH) complicated with hepatopulmonary syndrome (HPS) Methods The clinical data of 52 patients with LCPH were retrospectively analyzed. According to the presence or absence of concurrent HPS, patients were divided into Ⅰ (concurrent HPS) group and Ⅱ (non-concurrent HPS) group. Nitric acid reductase method was used to detect plasma NO levels, and plasma ET-1 levels were determined by radioimmunoassay. Results The overall incidence of HPS was 11.5% (6/52) and that of Child-Pugh C was 30% (3/10). The level of Child-Pugh C in group Ⅰ was 50% (3/6) and the level of plasma NO was (110.40 ± 28.02) μmol / L in group Ⅰ, which was significantly higher than that in group Ⅱ (P <0.01) There was no significant difference between the two groups (P> 0.05). Conclusions Elevated plasma NO level is an important feature of HPS. It suggests that the combination of Child-Pugh classification of liver function may be of diagnostic significance for LCPH complicated with HPS.