摘要
目的探讨肝硬变患者血浆生长抑素变化的意义．方法用ＲＩＡ法测定临床诊断为肝硬变的患者４９例和正常对照者３６例，空腹血浆生长抑素（ＳＳ）含量，对肝硬变患者行内镜检查，并检测甲胎蛋白（ＡＦＰ）、透明质酸（ＨＡ）、甘胆酸（ＣＧ）等．分析肝硬变及其不同并发症时ＳＳ的变化．结果血浆ＳＳ含量（ｎｇ／Ｌ）在肝硬变Ｂ级组（２２例）为４７１±２２０，Ｃ级组（２７例）为６６０±３３５；对照组为６１２±１７０．Ｂ级组与Ｃ级组及正常对照组比较Ｐ＜００１．肝硬变并发肝癌及肝肾综合征患者的ＳＳ水平分别为９３８±２７１和９３３±１１７，与无肝癌（４８２±２３２）及无肝肾综合征组（５５１±２９６）比较，Ｐ＜００１．血浆ＳＳ浓度在肝硬变有食管静脉曲张（ＥＶ），胃粘膜病变（ＧＭＬ）及出血组分别为５１２±３００，４１２±２１２及４３０．±２１７，与无ＥＶ（７３１±２５７）、无ＧＭＬ（６６２±３０９）及无出血组（６２７±３１３）相比均显著降低（Ｐ＜００５）．ＳＳ与ＡＦＰ呈正相关（ｒ＝０４３９，Ｐ＜００１）．结论肝硬变时血浆ＳＳ的变化与肝硬变多种并发症的出现有关；ＳＳ增高有可能作为肝硬变并?
AIM To investigate the significance of serum somatostatin (SS) changes in liver cirrhosis. METHODS Plasma levels of SS in 49 patients with liver cirrhosis and 36 healthy controls were measured by radioimmunoassay. For liver cirrhosis patients, gastroscopy and some serology (AFP, HA, CG, etc) were performed. Changes of plasma SS in cirrhosis and cirrhosis with different complications were analysed. RESULTS Plasma levels of SS(ng/L) in patients of class B group (47 1±22 0) were lower than those in class C(66 0±33 5) and normal control groups (61 2±17 0, P <0 01). Higher plasma levels of SS were found in cirrhotic patients with primary liver carcinoma (PLC) (93 8±27 1) and with hepatorenal syndrome (HRS) (93 3±11 7) than those without PLC (48 2±23 2) and HRS (55 1±29 6), respectively ( P <0 01). Plasma levels of SS were lower in patients with esophageal varices (EV), gastric mucosal lesion (GML) and bleeding than those without EV, GML and bleeding (51 2±30 0 vs 73 1±25 7, 41 2±21 0 vs 66 2±30 0 and 43 0±21 7 vs 62 7±31 3, P <0 05). A positive correlation was observed between SS and AFP ( r =0 439, P <0 01). CONCLUSION Plasma SS changes in liver cirrhosis may be related to the occurrence of various complications; and elevated plasma SS may have some diagnostic value in cirrhosis with PLC; and GI bleeding induced by EV and GML in cirrhosis may be correlated with the lower level of plasma SS.
关键词
肝硬变
血液
生长抑素
肝肿瘤
liver cirrhosis/blood
somatostatin/blood
liver neoplasms/blood
