摘要
目的了解肝硬变患者血浆一氧化氮（ＮＯ）含量及血清促卵泡素（ＦＳＨ）、促黄体素（ＬＨ）、泌乳素（ＰＲＬ）、雌二醇（Ｅ２）、睾酮（Ｔ）浓度，并探讨ＮＯ与性激素水平改变及某些临床表现的关系．方法肝硬变组５０例，全部为男肝炎后肝硬变患者，平均年龄５９岁±２６岁．其中１３例经Ｂ型超声证实无腹水，３７例有少量以上腹水．对照组３０例，为男性健康志愿者和献血员，平均年龄５２岁±１１岁．经方差分析肝硬变组和对照组年龄无显著差异（Ｐ＞００５）．我们研究采用高压液相色谱法测定ＮＯ血浆代谢产物亚硝酸根（ＮＯ－２）和硝酸根（ＮＯ－３）浓度，间接反应体内ＮＯ水平；采用放射免疫分析法测定血中ＦＳＨ，ＬＨ，ＰＲＬ，Ｅ２，Ｔ浓度．结果肝硬变患者血浆ＮＯ水平（ｎｇ／Ｌ）极显著高于对照组（３４８９±６７１ｖｓ２４３０±４７９，Ｐ＜００１），血清ＰＲＬ（μｇ／Ｌ），Ｅ２（ｎｇ／Ｌ）显著高于对照组（４０±２０ｖｓ２０±７，Ｐ＜００１；７０±２１ｖｓ４７±１３，Ｐ＜００１），Ｔ水平（ｎｇ／Ｌ）显著低于对照组（３５４±１０３ｖｓ５８８±８６，Ｐ＜００１），ＦＳＨ，ＬＨ两组差异无显著性．血浆ＮＯ水平与清蛋白（Ａ）呈负相关（ｒ＝－０６１，Ｐ＜０?
AIM The levels of plasma nitric oxide (NO), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E 2) and testosterone (T) in cirrhotic patients were measured to study the relationships between them and some clinical features. METHODS Fifty hospitalized male patients with hepatitis B or C virus related cirrhosis and 30 age-, sex matched healthy subjects were included in the present case control study. Ascites were estimated using abdominal ultrasound in cirrhotic group. Since NO is degraded into nitrous ions in vivo , the plasma nitrite (NO - 2) and nitrate (NO - 3) levels as an index for endogenous NO were measured using high performance liquid chromatography with an anion exchange column. The serum levels of FSH, LH, PRL, E2 and T were determined by radioimmunoassay (RIA). RESULTS In cirrhotic group, the plasma NO (ng/L) was significantly higher than control group (3489±671 vs 2430±479, P <0 001). The serum PRL (μg/L) and E 2 levels (ng/L) were significantly higher than control group (40±20 vs 20±7, P <0 01; 70±21 vs 47±13, P <0 01). The serum T level (ng/L) was significantly lower than control group (354±103 vs 588±86, P <0 01). No difference was found in serum FSH and LH levels between the two groups. The plasma level of NO was negatively correlated with the blood levels of albumin (A) ( r =-0 61, P <0 01) positively with ICG R ( r =0 64, P <0 01). not correlated with total bilirumbin (TB) ( r =0 20, P >0 05), prothrombin time (PT) ( r =0 13, P >0 05) and ALT ( r =0 16, P >0 05). The plasma NO (ng/L) was higher in cirrhotic patients with ascites than without ascites (3654±878,3137±868, P <0 01; 107±35 vs 72±28, P <0 05). The plasma level of NO was inversely related to the serum level of T ( r =-0 40, P <0 05). CONCLUSION Impairment of liver function may play an important role in elevation of the plasma NO level. The rise of plasma NO appears to be responsible for the formation of ascites. NO may inhibit the synthesis and release of testosterone in cirrhotic patients.
关键词
肝硬化
一氧化氮
血液
性激素类
血液
liver cirrhosis
nitric oxide/blood
sex hormones/blood
