肝纤维化门静脉压力改变与血清ET-1/NO关系的实验研究

目的制作兔肝纤维化模型，观察血管活性物质与门静脉压力变化的关系。方法40只家兔采用口服硫代乙酰胺方法造模，分别于造模第8、12、16、20周时检测内皮素（ET-1）及NO浓度，超声观察胆囊壁及肝脏血流动力学指标，直接穿刺测量不同时期门静脉压力。分析血管活性物质与肝脏血流动力学指标及门静脉压力变化间的关系。结果胆囊壁增厚是肝纤维化阶段的二维超声表现；随着纤维化程度的加重，血清ET-1、NO浓度逐渐增加，且以ET-1／N0比值增加更为明显；门静脉内压力、肠系膜上动脉、脾动脉搏动指数（PI）随纤维化程度逐渐增加，实验组与对照组间差异有统计学意义（P〈0．05），且与ET-1／NO值呈正相关（P〈0．01）。结论通过超声可无创检测肝脏血流动力学变化，对肝纤维化临床诊断及治疗效果的观察，具有积极的作用。

Experimental study on portal vein pressure changes and serum ET-1/NO level in hepatic fibrosis

Objective To study the portal vein pressure changes and serum ET-1/ NO level in rabbit hepatic fibrosis models. Methods Forty rabbits were fed with thioacetamide solution as the only drinking material,then the concentration of serum ET-1/ NO and hemodynamic index of portal vein system were detected at the 8th week,12th week,16th week and 20th week during constructing the hepatic fibrosis models. The relation between ET-1/NO and portal vein pressure changes were analized. Results The two-dimensional ultrasound image showed thickness of gallblader. With development of hepatic fibrosis,the serum level of ET-1,NO increased and the ratio of ET-1/NO increased obviously. Portal vein pressure and hemodynamics(PI) of superior mesenteric artery(SMA),spleen artery were significantly different between the control and study groups(P < 0.05). There was positive association between portal vein pressure and ratio of ET-1/NO(P < 0.01). Conclusion The detection of hepatic hemodynamic changes with ultrasound is useful in clinical diagnosis of hepatic fibrosis.