王毅 , 李敏 , 張偉
  • 遂寧市中心醫院肝膽外科（四川遂寧，629000）;
降鈣素基因相關肽 肝硬化 門靜脈高壓 食管下段胃底靜脈曲張
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【摘要】　目的　 研究降鈣素基因相關肽（calcitonin gene related peptide， CRGP）在肝硬化門靜脈高壓癥患者食管下段胃底靜脈曲張中的作用。　方法　 以2005年1月－2010年8月46例肝硬化門靜脈高壓癥不同程度食管下段胃底靜脈曲張患者作為研究對象，并按食管下段胃底靜脈曲張嚴重程度分為輕度曲張組、中度曲張組、重度曲張組，以30例行胃腸疾病手術無肝病患者作為對照。術中水柱法測定門靜脈壓力；酶聯免疫吸附法測定門靜脈血中CGRP含量。　結果　 對照組及輕、中、重度曲張組門靜脈壓力分別為（14.8±2.1）、（30.5±2.5）、（44.3±3.2）、（47.6±3.8） cm H2O（1 cm H2O=0.098 kPa）。門靜脈血中CGRP的含量分別為（45.4±5.4）、（69.2±7.2）、（93.6±8.7）、（98.2±9.4） pg/mL。對照組門靜脈壓力及CGRP含量明顯低于其他3組（P lt;0.05），在輕度曲張組明顯低于中度和重度曲張組（P lt;0.05），中度和重度曲張組之間差異無統計學意義（P gt;0.05）。　結論　 CRGP在肝硬化門靜脈高壓癥食管下段胃底靜脈曲張的發生和發展中起重要作用，CGRP可作為反映食管靜脈曲張程度的一種有用指標。
【Abstract】　Objective　 To investigate the role of calcitonin gene related peptide (CRGP) in pathogenesis of esophageal varices in portal hypertension with cirrhosis.　Methods　 from January 2005 to August 2010, 46 patients with portal hypertension and cirrhosis at different degrees of esophageal varices were divided into mild varicose group, moderate varicose group and severe varicose group according to the severity of esophageal varices. The patients who underwent gastrointestinal surgery without liver disease were as the control. Portal vein pressure was detected by mercury during the surgery. The expression of CGRP was assayed by enzyme-linked immunosorbent assay.　Results　 The portal pressure was (14.8±2.1), (30.5±2.5), (44.3±3.2), and (47.6±3.8) cm H2O (1 cm H2O=0.098 kPa) in the control group and the mild, moderate and severe varicose group, respectively. Those CGRP content in the portal vein was (45.4±5.4), (69.2±7.2), (93.6±8.7), and (98.2±9.4) pg/mL, respectively. CGRP content and portal vein pressure were the lowest in control group, which were significantly lower than those in the other three groups (P lt;0.05); which were also significantly lower in mild varicose group than those in the moderate and severe esophageal varices group (P lt;0.05), while no statistic difference between moderate and severe esophageal varices group was found (P lt;0.05).　Conclusion　 CGRP plays an important role in the occurrence and development of portal hypertension with cirrhosis concurrent esophageal varices, and it may serve as a useful indicator reflecting the degree of esophageal varices.

引用本文： 王毅,李敏,張偉. 降鈣素基因相關肽在肝硬化門靜脈高壓癥食管下段胃底靜脈曲張中的作用. 華西醫學, 2011, 26(7): 1043-1045. doi: 復制