摘要
30例慢活肝郁胆和20例慢重肝患者的 cAMP、cGMP 及其比值的结果表明,cAMP 与中医分型无一致关系,cGMP 升高及 cAMP/cGMP 比值降低以脾肾阳虚型最明显;Bil>513μmol/L 组的 cAMP、cGMP 均高于<513μmol/L 组(P<0.01),但其比值无明显差异;慢重肝的 cAMP、cGMP 及比值改变比慢活肝明显(P<0.05)。认为 cGMP 进行性上升是正气虚损、病情复杂、预后严重的标志之一。
Plasma of cAMP and cGMP in 30 cases of chronic active hepatitis (group of cholestatic patients) as well as in 20 cases of chronic hepatitis with submassive or massive necrosis (group of chronic severe hepatitis patients) were studied with ^(125)Ⅰ-marked radioimmunoassay.50 cases with their serum bilirubin levels higher than 171μmol/L were selected as subjects for this study.Among them,42 were diagnosed as hepatitis B,6 as coinfection of hepatitis A and B.According to differentiation of symptoms and signs of TCM,24 were diagnosed as simple hepatitis due to blood stasis and blood heat,17 as hepatitis due to blood stasis and blood heat accompanying symptoms of Yang(阳) deficiency of the Spleen and Kidney.20 healthy persons were selected as controls. The results were as follows:cAMP was 56.82±25.54 ng/L and 80.32±20.73 ng/L,and cGMP was 9.07±6.56 ng/L and 19.49±9.34 ng/L in the group of cholestatic patients and in the group of chronic severe hepatitis patients respectively.Both were higher than those in the control group whose cAMP was 14.12±3.25 ng/L and cGMP was 5.87±1.44 ng/L(P<0.01).Increase in cGMP and decrease in the ratio of cAMP and cGMP in the cases accompanying symptoms of Yang deficiency of the Spleen and Kidney were much higher than those in the other two types of hepatitis patients (P<0.01 and 0.05). cAMP and cGMP in the cases with their bilirubin levels higher than 513μmol/L were much higher than those in the cases with their bilirubin levels lower than 513 μmol/L (P<0.01),but the ratio of cAMP and cGMP was similar.Increase in cAMP and cGMP and decrease in their ratio in the cases of chronic severe hepatitis were significantly higher than those in the cases of chronic hepatitis (P< 0.01 and 0.05).The authors' conclusion is that progressive increase in cAMP especially in cGMP in cases of chronic severe icteric hepatitis is one of the objective indices for vital-Qi(气)consumption, exacerbation of patient's conditions,and unfavourabIe prognosis.
