肝硬化合并和不合并肝肺综合征患者的临床症状、实验室检查结果与血清内皮素-1浓度之间的关联。

The association between clinical symptoms, laboratory findings and serum endothelin 1 concentrations, in cirrhotic patients with and without hepatopulmonary syndrome.

作者信息

Khoshbaten Manouchehr, Rostami Nejad Mohammad, Ansarin Khalil, Fatemi Reza, Dulaimi David Al, Derakhshan Faramarz, Jafarinia Nagmeh, Barford Sophie, Zali Mohammad Reza

机构信息

Liver and gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Gastroenterol Hepatol Bed Bench. 2012 Winter;5(Suppl 1):S13-9.

PMID:24834232

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4017483/

Abstract

AIM

This study evaluated the association between serum endothelin- 1 level and symptoms, clinical examination, laboratory and cardio-respiratory parameters, in patients with cirrhosis compared to controls.

BACKGROUND

Cirrhosis is associated with significant portal, pulmonary and systemic vascular abnormities. Recent studies have suggested that endothelin -1 may have a significant role in the regulation of vascular tone.

PATIENTS AND METHODS

In this case - control study, subjects that had been evaluated and diagnosed with biopsy-proven cirrhosis and age-matched controls with no evidence of cardio-vascular or liver disease were recruited. Review of medical records, routine laboratory investigations and cardio-respiratory investigations including echocardiography to look for evidence of hepato-pulmonary syndrome were performed.

RESULTS

50 patients were subjects were recruited. The most common aetiology of the cirrhosis was chronic hepatitis B viral infection. 7/50 cases had evidence of the hepatopulmonary syndrome. Among the patients with evidence of the hepatopulmonary syndrome, dyspnoea (100%) and cyanosis (90%) were the most common of the symptoms and signs recorded. Pao2 and arterial - alveolar oxygen gradients were the most sensitive tests in the diagnosis of hepatopulmonary syndrome. Orthodoxy specificity was 100%. The median concentration of serum endothelin-1 in cases with hepatopulmonary syndrome was 1.06+/- 0.015 pg/ml (range 0.92 - 1.21), in cases of sub-clinical hepatopulmonary syndrome, 2.49+/- 0.08 (4.05- 0.93) in patients with cirrhosis but no evidence of hepatopulmonary syndrome criteria 0.85+/-0.74(1.06-0.64) in controls.

CONCLUSION

There was a significant difference in serum endothelin- 1 levels between patients with cirrhosis and controls, but not between patients with cirrhosis complicated by hepatopulmonary syndrome and controls.

摘要

目的

本研究评估了肝硬化患者与对照组相比，血清内皮素 -1 水平与症状、临床检查、实验室及心肺参数之间的关联。

背景

肝硬化与显著的门静脉、肺血管及全身血管异常相关。近期研究表明，内皮素 -1 可能在血管张力调节中起重要作用。

患者与方法

在这项病例对照研究中，招募了经活检证实为肝硬化的受试者以及年龄匹配、无心血管或肝脏疾病证据的对照组。进行了病历审查、常规实验室检查以及包括超声心动图在内的心肺检查，以寻找肝肺综合征的证据。

结果

共招募了 50 名受试者。肝硬化最常见的病因是慢性乙型肝炎病毒感染。50 例中有 7 例有肝肺综合征的证据。在有肝肺综合征证据的患者中，呼吸困难（100%）和发绀（90%）是记录到的最常见症状和体征。动脉血氧分压（Pao2）和动脉 - 肺泡氧梯度是诊断肝肺综合征最敏感的检查。正位胸片特异性为 100%。肝肺综合征患者血清内皮素 -1 的中位浓度为 1.06±0.015 皮克/毫升（范围 0.92 - 1.21），亚临床肝肺综合征患者为 2.49±0.08（4.05 - 0.93），肝硬化但无肝肺综合征标准证据的患者为 0.85±0.74（1.06 - 0.64），对照组为 0.85±0.74（1.06 - 0.64）。