Langer M, Masala A, Alagna S, Rassu S, Madeddu G, Solinas A, Chiandussi L
Clin Endocrinol (Oxf). 1981 Feb;14(2):189-92. doi: 10.1111/j.1365-2265.1981.tb00615.x.
Elevated plasma concentrations and abnormal secretory patterns of GH have been found in patients with cirrhosis of the liver. Displacement of brain dopaminergic monoamines by false "neurotransmitters' produced in the gut has been postulated as a cause of encephalopathy. In this study basal GH plasma levels and their response to TRH and L-DOPA were determined in thirty-nine cirrhotic patients and fifteen controls. Eleven patients had evidence of encephalopathy (Group 1), twenty-eight did not (Group 2). Both basal levels and the mean peak response to TRH were significantly higher in the cirrhotic patients that in the controls (Group 3). Peak values were moderately, but not significantly, higher in Group 1 than in Group 2. The response to L-DOPA was considerably lower in the encephalopathic patients in comparison with the subjects of both Group 2 and Group 3. This finding is consistent with depletion of active "neurotransmitters' in CNS. Our data fail to demonstrate clearly whether the paradoxical response to TRH can also be related to these abnormalities of monoamine metabolism in cirrhotics.
肝硬化患者中已发现生长激素（GH）的血浆浓度升高及分泌模式异常。肠道中产生的假性“神经递质”取代脑内多巴胺能单胺被认为是肝性脑病的一个病因。在本研究中，测定了39例肝硬化患者和15例对照者的基础GH血浆水平及其对促甲状腺激素释放激素（TRH）和左旋多巴（L-DOPA）的反应。11例患者有肝性脑病证据（第1组），28例无（第2组）。肝硬化患者的基础水平及对TRH的平均峰值反应均显著高于对照组（第3组）。第1组的峰值略高于第2组，但无显著差异。与第2组和第3组的受试者相比，肝性脑病患者对L-DOPA的反应明显较低。这一发现与中枢神经系统中活性“神经递质”的耗竭一致。我们的数据未能明确证明对TRH的反常反应是否也与肝硬化患者单胺代谢的这些异常有关。
