1型肝肾综合征患者内毒素和内皮素1水平分析

高宝秀; 聂鑫; 贺勇; 杨正兵; 罗通行; 宋昊岚; 李贵星

doi:10.3969/j.issn.1001-5256.2014.01.016

1型肝肾综合征患者内毒素和内皮素1水平分析

DOI: 10.3969/j.issn.1001-5256.2014.01.016

1. 四川大学华西医院实验医学科
2. 四川大学华西医院消化内科

基金项目:

四川省科技支撑项目(2010SZ0252)；

详细信息

中图分类号: R575.2
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出版历程
- 收稿日期: 2013-05-13
- 出版日期: 2014-01-20

Analysis of endotoxin and endothelin-1 levels in patients with type 1 hepatorenal syndrome

Department of Laboratory Medicine, West China Hospital, Sichuan University

Research funding:

摘要

摘要:
目的分析肝硬化腹水伴1型肝肾综合征（HRS）患者的临床资料、实验室指标、感染发生率、血清降钙素原（PCT）和内皮素1（ET-1）水平,探讨内毒素和ET-1在HRS发生中的作用。方法纳入本院2009年1月至2012年10月住院的肝硬化腹水伴1型HRS患者56例（HRS组）及肝硬化伴腹水且肾功能正常患者60例（非HRS组）,收集2组患者的一般资料、肝硬化病因、感染发生率及类型、Child-Pugh分级、全身炎症反应综合征（SIRS）评分及平均动脉压（MAP）;同时采集2组患者血液,分析肝肾功能、电解质、PCT、ET-1水平。比较2组患者的临床资料和检测指标。计数资料采用χ2检验,正态分布计量资料组间比较采用成组t检验,非正态分布计量资料组间比较采用Wilcoxon秩和检验。结果 HRS组感染发生率为75.0%,显著高于非HRS组的28.4%（χ2=11.91,P<0.05）。HRS组PCT、ET-1和SIRS分别为8.72（3.14,31.68）ng/L、（13.04±2.82）pg/ml和2.1±1.1,高于非HRS组的0.11（0.04,0.45）ng/L、（5.76±1.68）...
- 肝肾综合征 /
- 肝硬化 /
- 内毒素类 /
- 内皮缩血管肽1
Abstract:
Objective To analyze the clinical data, laboratory parameters, infection rate, and serum procalcitonin ( PCT) and ET- 1 levels of patients with cirrhotic ascites and type 1 hepatorenal syndrome ( HRS) and to investigate the roles of endotoxin and ET- 1 in the development of HRS. Methods Between January 2009 and October 2012, 56 inpatients with cirrhotic ascites and type 1 HRS ( HRS group) and 60 inpatients with cirrhotic ascites who had normal renal function ( non- HRS group) were included in the study. Their general data, causes of liver cirrhosis, infection rates and types, Child- Pugh classification, systemic inflammatory response syndrome ( SIRS) score, and mean arterial pressure ( MAP) were recorded; blood samples were collected to evaluate liver and renal function and measure serum electrolyte, PCT, and ET- 1 levels. The clinical data and laboratory parameters were compared between the two groups. Categorical data were analyzed by chi-square test; comparison of normally distributed continuous data between the two groups was made by independent- samples t test, and comparison of non- normally distributed continuous data between the two groups was made by Wilcoxon rank sum test. Results The infection rate of HRS group ( 75. 0%) was significantly higher than that of non- HRS group ( 28. 4%) ( χ2= 11. 91, P < 0. 05) . The PCT and ET- 1 levels and SIRS score of HRS group [8. 72 ( 3. 14, 31. 68) ng / L, 13. 04 ± 2. 82 pg / ml, and 2. 1 ± 1. 1]were significantly higher than those of non-HRS group [0. 11 ( 0. 04, 0. 45) ng / L, 5. 76 ± 1. 68 pg / ml, and 0. 6 ± 0. 6] ( P < 0. 05) . In addition, the HRS group had significantly higher serum urea, creatine, cystatin C, and K levels than the non- HRS group ( P < 0. 05) , while the HRS group had significantly lower Na and Cl levels than the non- HRS group ( P < 0. 05) . There were no significant differences in ALT and AST levels between the two groups ( P > 0. 05) . Conclusion Endotoxin causes elevated expression of ET- 1, and ET- 1 induces renal perfusion deficiency by intense renal vasoconstriction, thus leading to type 1 HRS. Endotoxin and ET- 1 are closely associated with the development of type 1 HRS.
- hepatorenal syndrome /
- liver cirrhosis /
- endotoxins /
- endothelin-1

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