摘要
目的 研究梗阻性黄疸 (梗黄 )患者血浆可溶性P -选择素 (sP selectin ,sP s)与内毒素 (ET )及D -二聚体 (D d)的关系及其意义。方法 应用ELISA和鲎试剂比色法测定梗黄组、急性胆囊炎组和健康人组血浆sP s ,D d和ET含量。结果 健康人组血浆sP s含量为 (93 .43± 17.65 )ng/ml ,ET (0 .0 0 3 0± 0 .0 0 0 4)EU /ml ,D d(0 .3 9± 0 .2 1)mg/L ;急性胆囊炎组血浆sP s含量为 (2 3 3 .3 2± 82 .12 )ng/ml ,ET (0 .40 12± 0 .15 0 6)EU /ml ,D d(0 .76± 0 .2 7)mg/L ;梗黄组血浆sP s含量为 (3 5 1.90± 93 .83 )ng/ml ,ET(0 .3 814± 0 .14 3 0 )EU /ml ,D d(2 .14± 0 .3 7)mg/L。急性胆囊炎组和梗黄组sP s ,D d及ET均高于健康人组 (P <0 .0 1) ;梗黄组ET与急性胆囊组差异无显著性 ,但梗黄组sP s和D d较急性胆囊炎组高 (P <0 .0 1) ,梗黄组的以上二物质含量呈正相关性 (P <0 .0 1) ;急性胆囊炎组sP s与ET呈正相关性 (P <0 .0 1)。协方差分析表明 ,在相同ET含量时 ,梗黄组sP s高于急性胆囊炎组 (P <0 .0 1) ,且与D d有相关性 ,二者有相同变化趋势。结论 胆道梗阻是ET致血管内皮细胞损伤和血小板活化的敏感性因素 ,梗黄患者血液高凝状态与继发性纤溶反应处于动态平衡 ,提示动态监测血浆sP s和D d变化 ,
Objective To analyse the significance and relation between soluble P-selectin (sP-selectin),D-dimer (D-d) and endotoxin (ET) in the patient with obstructive jaundice (OJ). Methods Blood plasma sP-selectin and D-d in OJ group,acute cholecystitis group and healthy group were detected by ELISA and ET was detected by the colorimetric method, Results In healthy group,the concentration of blood plasma sP-selectin was ( 93.43 ± 17.65 ) ng/ml,ET(0.0030±0.0004)EU/ml,and D-d(0.39±0.21)mg/L; in acute cholecystitis group,sP-selectin was (233.32±82.12) ng/ml, ET(0.4012±0.1506) EU/ml,and D-d(0.76±0.27)mg/L; in OJ group,sP-selectin was (351.90±93.83) ng/ml ,ET (0.3814±0.1430)EU/ml,and D-d(2.14±0.37)mg/L.The sP-selectin, D-d and ET in the acute cholecystitis group and the OJ group were higher than those in healthy group (P < 0.01).ET showed no statistical difference between OJ group and acute cholecystitis group (P>0.05). sP-selectin and D-d in the OJ group were significantly higher than that in the acute cholecystitis group (P < 0.01). sP-selectin had positive correlation with ET in OJ group and acute cholecystitis group. At the same level of ET, sP-selectin level in OJ group was significantly higher than that in the acute cholecystitis group.The change of sP-selectin had positive correlation with D-d in OJ group(P < 0.01). Conclusions OJ is a activeite factor of endothelial cell injury and platelet activation which were induced by endotoxin.There is a balance between high coagulation and secondary increased fibrinolytic activity in OJ. When sP-selectin and D-d are detected, may help to know the dysfunction degree of blood coagulation in OJ
出处
《中国普通外科杂志》
CAS
CSCD
2002年第10期605-608,共4页
China Journal of General Surgery
