Higaki I, Yamazaki O, Matsuyama M, Horii K, Kawai S, Tsukamoto T, Tanaka H, Kubo S, Hirohashi K, Kinoshita H
Second Department of Surgery, Osaka City University Medical School, Osaka, Japan.
Hepatogastroenterology. 1999 May-Jun;46(27):1599-602.
BACKGROUND/AIMS: Endothelin-1, a potent vasoconstrictive peptide, is known to modulate changes in local circulation. Additionally, hepatocyte growth factor, a potent mitogen for hepatocytes, is increased in various liver diseases. The present study examined changes in serum endothelin-1 and hepatocyte growth factor levels in patients with obstructive jaundice before and after percutaneous transhepatic cholangio drainage.
Endothelin-1 and hepatocyte growth factor levels were measured by enzyme-linked immunosorbent assay using sera from 16 patients with obstructive jaundice before and after percutaneous transhepatic cholangio drainage.
Serum endothelin-1 levels decreased rapidly in the good bilirubin decrease group after biliary drainage. Endothelin-1 levels decreased 1 week after drainage but then increased gradually in the worse bilirubin decrease group. Serum hepatocyte growth factor levels decreased gradually after biliary drainage, and were higher in the worse bilirubin decrease group than in the good bilirubin decrease group throughout the study.
These results suggest that endothelin-1 may be associated with the microcirculatory disturbance in obstructive jaundice and prolonged cholestasis. Measurement of hepatocyte growth factor levels in patients with obstructive jaundice before percutaneous transhepatic cholangio drainage may be an early clinical predictor of the subsequent rate of decrease of the serum bilirubin concentration.
背景/目的:内皮素-1是一种强效血管收缩肽,已知可调节局部循环的变化。此外,肝细胞生长因子是一种对肝细胞有强效促有丝分裂作用的因子,在各种肝脏疾病中会升高。本研究检测了经皮经肝胆道引流前后梗阻性黄疸患者血清内皮素-1和肝细胞生长因子水平的变化。
采用酶联免疫吸附测定法,检测16例梗阻性黄疸患者经皮经肝胆道引流前后血清中的内皮素-1和肝细胞生长因子水平。
在胆红素下降良好组,胆道引流后血清内皮素-1水平迅速下降。在胆红素下降较差组,引流1周后内皮素-1水平下降,但随后逐渐升高。胆道引流后血清肝细胞生长因子水平逐渐下降,且在整个研究过程中,胆红素下降较差组的水平高于胆红素下降良好组。
这些结果表明,内皮素-1可能与梗阻性黄疸和长期胆汁淤积中的微循环障碍有关。在经皮经肝胆道引流前检测梗阻性黄疸患者的肝细胞生长因子水平,可能是血清胆红素浓度随后下降速率的早期临床预测指标。