Yang Ying-Ying, Lin Han-Chieh, Lee Wui-Chiang, Huang Yi-Tsau, Hou Ming-Chih, Lee Fa-Yauh, Chang Full-Young, Lee Shou-Dong
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, and Institute of Traditional Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
J Gastroenterol Hepatol. 2003 Oct;18(10):1156-61. doi: 10.1046/j.1440-1746.2003.03144.x.
The level of plasma erythropoietin (EPO) in patients with cirrhosis is controversial. It is known that overproduction of nitric oxide (NO) plays, in part, a role for the development of peripheral arterial vasodilatation in cirrhosis with portal hypertension. It has also been hypothesized that a possible interaction is noted between endogenous EPO and NO production. The current study was undertaken to evaluate the relationship between plasma EPO levels and the severity of liver disease, hemodynamic values, renal functions, and plasma nitrate/nitrite levels in patients with cirrhosis.
The authors measured the biochemistry, plasma EPO and nitrate/nitrite levels in 67 patients with cirrhosis (Child-Pugh class A in 23 and Child-Pugh class B and C in 44) and compared their values with those in 34 healthy subjects. Systemic and splanchnic hemodynamic measurements and effective renal plasma flow were obtained from cirrhotic patients.
Plasma EPO and nitrate/nitrite levels were significantly increased in patients with cirrhosis compared with healthy subjects. Additionally, plasma EPO values were higher in cirrhotic patients with ascites or with anemia than in those without ascites or without anemia, respectively. Plasma EPO levels were positively correlated to the hepatic venous pressure gradient (HVPG) and Child-Pugh score, negatively correlated to the renal and hepatic blood flows, but were not correlated to nitrate/nitrite level and systemic vascular resistance in cirrhotic patients. Multiple regression analysis showed that HVPG and renal plasma flow were independent predictors for the elevated EPO level in cirrhotic patients.
Plasma EPO levels were increased in patients with cirrhosis compared with those in healthy subjects. The increase in plasma EPO levels is related to the degree of portal hypertension, the severity of cirrhosis and the renal plasma flow. In contrast, the EPO levels had no correlation to the nitrate/nitrite levels and systemic vascular resistance in patients with cirrhosis.
肝硬化患者血浆促红细胞生成素（EPO）水平存在争议。已知一氧化氮（NO）的过度产生在一定程度上参与了肝硬化伴门静脉高压时外周动脉血管扩张的发生。也有假说认为内源性EPO与NO产生之间可能存在相互作用。本研究旨在评估肝硬化患者血浆EPO水平与肝病严重程度、血流动力学指标、肾功能及血浆硝酸盐/亚硝酸盐水平之间的关系。
作者测定了67例肝硬化患者（23例Child-Pugh A级，44例Child-Pugh B级和C级）的生化指标、血浆EPO及硝酸盐/亚硝酸盐水平，并将其值与34例健康受试者的值进行比较。对肝硬化患者进行了全身和内脏血流动力学测量以及有效肾血浆流量测定。
与健康受试者相比，肝硬化患者血浆EPO和硝酸盐/亚硝酸盐水平显著升高。此外，有腹水或贫血的肝硬化患者血浆EPO值分别高于无腹水或无贫血的患者。肝硬化患者血浆EPO水平与肝静脉压力梯度（HVPG）和Child-Pugh评分呈正相关，与肾血流量和肝血流量呈负相关，但与血浆硝酸盐/亚硝酸盐水平及全身血管阻力无关。多元回归分析显示，HVPG和肾血浆流量是肝硬化患者EPO水平升高的独立预测因素。
与健康受试者相比，肝硬化患者血浆EPO水平升高。血浆EPO水平的升高与门静脉高压程度、肝硬化严重程度及肾血浆流量有关。相比之下，肝硬化患者的EPO水平与硝酸盐/亚硝酸盐水平及全身血管阻力无关。
