摘要
目的研究肝硬变患者前列腺素Ｅ１治疗后血清ＨＡ，ＰⅢＰ，ＣⅣ变化的临床意义．方法采用特异ＲＩＡ测定７０例肝硬变患者和３０例正常人血清透明质酸（ＨＡ）、Ⅲ型前胶原肽（ＰⅢＰ）、血清Ⅳ型胶原（ＣⅣ）的含量．肝硬变患者随机分成两组，对照组３０例为综合治疗组，实验组为综合治疗加前列腺素Ｅ１（ＰＧＥ１）．两组治疗前以上观察指标无显著差异（Ｐ＞００５）．按Ｃｈｉｌｄ分级，治疗前患者血清ＨＡ，ＰⅢＰ，ＣⅣ水平两组均为Ａ级＜Ｂ级＜Ｃ级．两组治疗４ｗｋ后再测定血清ＨＡ，ＰⅢＰ，ＣⅣ含量．结果肝硬变患者血清ＨＡ，ＰⅢＰ，ＣⅣ明显高于正常组（μｇ／Ｌ；９８２±６５８，２４８±４６，１６８±４１，ｖｓ２５３±１０，９３±１８，８１±３１；Ｐ＜００１）．实验组Ａ，Ｂ两级患者治疗后血清ＨＡ，ＰⅢＰ，ＣⅣ显著下降，Ａ级：４２９±３２６，１６６±１２，１２６±２１；Ｂ级：６８６±４１９，２６７±２１，１６９±３０；ｖｓＡ级：２６９±１５１，９６±２０，８６±１０，Ｂ级：４１９±３２６，１５０±３６，１１１±３１；Ｐ＜００１）．对照组治疗后血清ＨＡ，ＰⅢＰ，ＣⅣ也下降，Ａ级：４３２±３２５，１６５±１２，１２８±２２，Ｂ级：６９０±４２?
AIM To study the clinical significance of alterations of serum hyaluronic acid, type Ⅲ procollagen and type Ⅳ collagen in patients with liver cirrhosis pre or post PGE1 treatment. METHODS Serum hyaluronic acid (HA), procollagen Ⅲ peptide (PⅢP) and collagen Ⅳ (CⅣ) were measured with radioimmunoassay in 70 patients with liver cirrhosis and 30 normal persons. The patients with hepatic cirrhosis were randomly divided into two groups. The control group ( n =30) were given comprehensive treatment for 4 weeks and the experimental group ( n =40) received extra prostagland in E1 (PGE1). The concentration of HA, PⅢP, CⅣ in Child class A was less than that of class B, which was less than that of class C, before the treatment (A<B<C). The concentrations of PⅢP, HA, CⅣ of the two groups were measured again four weeks later. RESULTS The concentrations of HA, PⅢP, CⅣ were significantly higher in liver cirrhosis (982±658,248±46,168±41) than in that in normal liver (253±10,93±18,81±31; P <0 01). The concentrations of HA,PⅢP,CⅣ after treatment in experimental group class A (269±151,96±20,86±10 and in class B 419±326,150±36,111±31) were markedly reduced, compared with that before the treatment (in class A 429±326,166±12,126±21, in class B 686±419,267±21,169±30, P <0 01). In class C these parameters did not show any reduction after treatment ( P >0 05). The concentrations of HA, PⅢP, CⅣ in control group were decreased in class A (339±220,123±20,102±20 and in class B 551±390,200±11,153±31) after the treatment (before treatment in class A 432±325,165±12,128±22, in class B 690±421,271±23,170±32). The difference was significant. ( P <0 05). In class C these parameters showed no reduction after the treatment ( P >0 05). CONCLUSION PGE1 could reduce the concentrations of HA, PⅢP, CⅣ in slight hepatic dysfunction patients with liver cirrhosis.
关键词
肝硬化
药物疗法
前列地尔
透明质酸
liver cirrhosis/drug therapy
alprostadil/therapeutic use
hyaluronic acid/blood
collagen/blood
