血浆肾上腺髓质素与肝硬化门静脉高压的相关性研究

摘要

Objective To observe the levels of plasma adrenomedullin(ADM)in liver cirrhosis and study the correlation of ADM and hemodynamics of portal vein in liver cirrhosis. Methods Ninety-eight patients with cirrhosis and 30 healthy persons as control were studied. The levels of plasma ADM were measured by radioimmunoassay. Portal vein systems were observed dynamically by color Dopper ulterasonography in order to judge the hemodynamics of portal vein in liver cirrhosis. Results The levels of plasma ADM in cirrhosis patients were distinctively higher than those in control group and increased with higher Child-Pugh grade( all P ＜0. 05). The levels of plasma ADM in cirrhosis patients with ascites were higher than those in patients without ascites ( P ＜ 0. 05) . With the increasing level of plasma ADM in cirrhosis patients, PVD, SVD, PVV,SVV, PVFV, and SVFV also increased( all P ＜0.05). Conclusions The level of plasmas ADM distinctivly correlates with liver diseases. The plasma ADM may play an important role in formation of the pressure of portal vein.%目的 观察肝硬化患者血浆肾上腺髓质素(ADM)的浓度变化,并探讨其与肝硬化门静脉高压的关系.方法 选择98例肝硬化患者,并设健康对照.应用放射免疫法检测血浆ADM,同期应用彩色多普勒超声对门静脉系统进行动态观察,以综合判断门静脉高压情况.结果 肝硬化患者血浆ADM明显高于健康对照,且随Child-Pugh分级增加而升高(P<0.05);肝硬化腹水患者血浆ADM明显高于肝硬化无腹水患者(P<0.05).肝硬化患者随血浆ADM升高,门静脉内径(PVD)、脾静脉内径(SVD)增加,门静脉血流速度(PVV)、脾静脉血流速度(SVV)降低,门静脉血流量(PVFV)、脾静脉血流量(SVFV)增加(P均<0.05).随着Child-Pugh分级增加,PVD、SVD增加,PVV、SVV降低,PVFV、SVFV增加(P均<0.05).结论 血浆ADM与肝脏病变程度及肝硬化门静脉高压密切相关,在门脉高压形成过程中可能起重要作用.