重庆医科大学学报
重慶醫科大學學報
중경의과대학학보
UNIVERSITATIS SCIENTIAE MEDICINAE CHONGQING
2010年
2期
234-237
,共4页
降钙素基因相关肽%内皮素%肝硬化%门静脉高压%食管静脉曲张套扎%酶联法
降鈣素基因相關肽%內皮素%肝硬化%門靜脈高壓%食管靜脈麯張套扎%酶聯法
강개소기인상관태%내피소%간경화%문정맥고압%식관정맥곡장투찰%매련법
CGRP%ET-1%Liver cirrhosis%Portal hypertension%Varices%Endoscopic variceal ligation%ELISA
目的:研究肝硬化合并食管静脉曲张患者套扎前后血浆降钙素基因相关肽(calcitonin gene reJatod peptide,CGRP)及内皮素(Endothelin-1,ET-1)水平的变化,寻找判断食管静脉曲张套扎术后疗效的简易指标.方法:采用酶联免疫分析法测定40例肝硬化(Liver eirrllosis,LC)合并食管静脉曲张(Esoplhageal varices,EV)患者行食管静脉曲张套扎术(Endoscopic variceal ligation,EVL)前后空腹血浆CGRP及ET-1水平.结果:食管静脉曲张套扎前后CGRP及ET-1水平均明显高于正常值,具有显著性意义(P<0.01).套扎术后CGRP水平显著高于套扎前,具有显著性意义(P<0.05).部分病例行两次套扎,再次套扎前CGRP水平较上次套扎前后均明显降低,差异有显著性意义(P<0.05).套扎后ET-1水平较套扎前有所降低,但差异无显著意义.结论:CGRP及ET-1升高在肝硬化门脉高压中起重要作用.套扎后CGRP水平变化情况与临床上套扎后发生上消化道出血的危险性变化相一致,因此CGRP水平可能与出血危险性有相关性.食管静脉曲张套扎术可降低侧枝循环压力,减轻食管静脉曲张程度,改善高动力循环状态.
目的:研究肝硬化閤併食管靜脈麯張患者套扎前後血漿降鈣素基因相關肽(calcitonin gene reJatod peptide,CGRP)及內皮素(Endothelin-1,ET-1)水平的變化,尋找判斷食管靜脈麯張套扎術後療效的簡易指標.方法:採用酶聯免疫分析法測定40例肝硬化(Liver eirrllosis,LC)閤併食管靜脈麯張(Esoplhageal varices,EV)患者行食管靜脈麯張套扎術(Endoscopic variceal ligation,EVL)前後空腹血漿CGRP及ET-1水平.結果:食管靜脈麯張套扎前後CGRP及ET-1水平均明顯高于正常值,具有顯著性意義(P<0.01).套扎術後CGRP水平顯著高于套扎前,具有顯著性意義(P<0.05).部分病例行兩次套扎,再次套扎前CGRP水平較上次套扎前後均明顯降低,差異有顯著性意義(P<0.05).套扎後ET-1水平較套扎前有所降低,但差異無顯著意義.結論:CGRP及ET-1升高在肝硬化門脈高壓中起重要作用.套扎後CGRP水平變化情況與臨床上套扎後髮生上消化道齣血的危險性變化相一緻,因此CGRP水平可能與齣血危險性有相關性.食管靜脈麯張套扎術可降低側枝循環壓力,減輕食管靜脈麯張程度,改善高動力循環狀態.
목적:연구간경화합병식관정맥곡장환자투찰전후혈장강개소기인상관태(calcitonin gene reJatod peptide,CGRP)급내피소(Endothelin-1,ET-1)수평적변화,심조판단식관정맥곡장투찰술후료효적간역지표.방법:채용매련면역분석법측정40례간경화(Liver eirrllosis,LC)합병식관정맥곡장(Esoplhageal varices,EV)환자행식관정맥곡장투찰술(Endoscopic variceal ligation,EVL)전후공복혈장CGRP급ET-1수평.결과:식관정맥곡장투찰전후CGRP급ET-1수평균명현고우정상치,구유현저성의의(P<0.01).투찰술후CGRP수평현저고우투찰전,구유현저성의의(P<0.05).부분병례행량차투찰,재차투찰전CGRP수평교상차투찰전후균명현강저,차이유현저성의의(P<0.05).투찰후ET-1수평교투찰전유소강저,단차이무현저의의.결론:CGRP급ET-1승고재간경화문맥고압중기중요작용.투찰후CGRP수평변화정황여림상상투찰후발생상소화도출혈적위험성변화상일치,인차CGRP수평가능여출혈위험성유상관성.식관정맥곡장투찰술가강저측지순배압력,감경식관정맥곡장정도,개선고동력순배상태.
Objective:To investigate the alteration of the level of plasma calcitonin gene related peptide(CGRP)and endothelin-1(ET-1) in liver cirrhosis with esophageal varices (EV) after endoscopic variceal ligation (EVL),searching for some facility indexes for the judgement of the effect of EVL.Methods:CGRP and ET-1 were measured in plasma sample collected from 40 liver cirrhosis patients with EV before and after EVL by ELISA.Results:Plasma CGRP and Et-l level were significantly higher than normal,no matter before or after EVL Plasma CGRP level after EVL was significantly higher than that before EVL(p<0.05).The plasma CGRP level before second EVL of some patients accepted twice EVL was significantly lower than that before or afterfirst EVL Plasma ET-1 level after EVL was not significantly lower than that before EVL.Conclusion:The increasing of CGRP and ET-l played an important role in portal hypertension caused by liver cirrhosis.The variation of the level of CGRP corresponded to the risk of upper gastrointestinal bleeding after EVL,so the level of CGRP could be related to the risk of upper gastrointestinal bleeding.The results showed that EVL could cut down the pressure of collateral circulation,and lessen the degree of EV.
