Ⅰ型肝肾综合征患者前列腺素I2和血栓素A2水平分析

摘要

Objective To explore the effect of arachidonic acid metabolism on the development of hepatorenal syndrome ( HRS) by analyzing clinical data, laboratory parameters, serum prostaglandin I2 ( PGI2 ) and thromboxane A2 ( TXA2 ) levels detected in cirrhosis patients with ascites and type 1 HRS. Methods Ninety - eight in - patients being treated for cirrhosis in our hospital were enrolled in the study. Clinical data and blood samples were collected for all study participants and used to assess liver function, renal function, and levels of electrolytes , PGI2 and TXA2. According to the results, the patients were classified as the HRS group (cirrhosis with ascites and type 1 HRS, n =48) or the non - HRS group (cirrhosis with ascites and normal renal function, n =50) , and the data of the two groups were comparatively analyzed. Results TXA2 level was significantly higher in the HRS group than in the non - HRS group (7432 ±2186 pg/ml vs. 5032 ± 2104 pg/ml, P<0.05). PGI2/TXA2 was significantly lower in the HRS group than in the non - HRS group (4.79±1.58 vs. 7.50 + 2. 38, P<0.05). PGI2 levels were similar between the two groups (P>0.05). Conclusion Imbalance in the PGI2/TXA2 ratio, both components of which are arachidonic acid metabolites, is closely associated with development of type 1 HRS in cirrhosis patients.%目的 通过分析肝硬化腹水伴Ⅰ型肝肾综合征(HRS)患者的临床资料、实验室指标、前列腺素I2(PGI2)和血栓素A2(TXA2),探讨花生四烯酸代谢与Ⅰ型HRS发生的关系.方法 纳入肝硬化腹水伴Ⅰ型HRS患者38例(HRS组)及肝硬化腹水且肾功能正常患者50例(非HRS组),收集两组患者的一般资料和血液,分析肝肾功能、电解质、PGI2和TXA2水平.结果 HRS组和非HRS组的PGI2、TXA2、PGI2/TXA2水平分别为(32517±6023) pg/ml、(7432±2186) pg/ml、4.79 ±1.58和(29 597±3343) pg/ml、(5032 ±2104)pg/ml、7.50±2.38,HRS组TXA2水平高于非HRS组(t=2.385,P=0.027),而PGI2/ TXA2水平低于非HRS组(t=2.29,P=0.035),两组PGI2水平差异无统计学意义(t=1.233,P=0.23).结论 Ⅰ型肝肾综合征患者PGI2/TXA2比例失调,花生四烯酸代谢异常可能和Ⅰ型HRS发生有关.