肝硬化患者中高血压病患病率相关分析

余灵祥; 谭钧元; 徐志伟; 靳雪源

doi:10.3969/j.issn.1001-5256.2014.11.023

肝硬化患者中高血压病患病率相关分析

DOI: 10.3969/j.issn.1001-5256.2014.11.023

1. 解放军第三二医院肝胆外科
2. 解放军第三二医院科训科
3. 解放军第三二医院国际肝病科

详细信息

中图分类号: R575.2
计量
- 文章访问数: 2800
- HTML全文浏览量: 13
- PDF下载量: 555
- 被引次数: 0
出版历程
- 收稿日期: 2014-03-14
- 出版日期: 2014-11-20

Study on prevalence of hypertension in patients with liver cirrhosis

Department of Hepatobiliary Surgery, 302 Hospital of PLA

摘要

摘要: 目的探讨肝硬化患者中高血压病的患病率情况,以及肿瘤坏死因子（TNFα）、胆碱酯酶（CHE）和P物质、一氧化氮（NO）、肾上腺髓质素（ADM）在其中的作用和意义。方法病例组纳入2013年3月-2014年2月入院的肝硬化患者134例;对照组纳入268例健康体检者,分别采集空腹血液样本并测定血清中TNFα、CHE、P物质、NO和ADM的值,对2组有高血压病患者的患病率以及上述指标进行比较。计量资料比较采用t检验,计数资料用卡方检验,等级资料采用Kruskal-Wallis H检验。结果肝硬化患者的高血压病的患病率为18.66%（25/134）,低于普通人群的患病率30.97%（83/268）。肝硬化伴高血压组的血清TNFα、P物质、NO、ADM水平均高于对照组有高血压病患者（t=25.464、16.649、19.772、13.835,P值均<0.05）,而血清CHE水平肝硬化伴高血压组低于对照组有高血压病患者（t=-50.257,P<0.05）。结论肝硬化患者高血压病的患病率低于普通人群,肝硬化的患者高血压患病率低可能与肝硬化患者扩血管因素如血清中升高的P物质、NO、ADM增多有...
- 肝硬化 /
- 高血压 /
- 肿瘤坏死因子α /
- 胆碱酯酶类 /
- P物质 /
- 一氧化氮 /
- 肾上腺髓质素
Abstract: Objective To investigate the prevalence of hypertension in patients with liver cirrhosis and its relationship with tumor necrosis factor alpha (TNFα) , cholinesterase (CHE) , substance P (SP) , nitric oxide (NO) , and adrenomedullin (ADM) . Methods A total of134 cirrhotic patients newly admitted to the hospital were selected as case group, and 268 subjects undergoing physical examination were selected as control group. Fasting blood was collected, and serum levels of TNFα, CHE, SP, NO, and ADM were determined. The two groups were compared with respect to the prevalence of hypertension and serum levels of TNFα, CHE, SP, NO, and ADM. Comparison of measurement data was made by t test, comparison of enumeration data was made by chi- square test, and comparison of ranked data was made by Kruskal- Wallis H test. Results The prevalence of hypertension for the case group (18. 66%, 25 /134) was lower than that for the control group (30. 97%, 83 /268) . Among patients with hypertension, the case group had significantly higher serum levels of TNFα, SP, NO, and ADM (t = 25. 464, 16. 649, 19. 772, and 13. 835, P < 0. 05 for all) but a significantly lower serum level of CHE ( t =- 50. 257, P < 0.05) , as compared with the control group. Conclusion Patients with liver cirrhosis has a lower prevalence of hypertension than the general population, which may be related to increases in serum vasodilating factors such as SP, NO, and ADM.
- liver cirrhosis /
- hypertension /
- tumor necrosis factor-alpha /
- cholines terases /
- substance P /
- nitric oxide /
- adrenomedullin

HTML全文

参考文献(21)

[1]LI DS, QIU XH, LIN XY.China Statistical Yearbook[M].Beijing:China Statistical Press, 2004:1146-1147. (in Chinese) 李德水, 邱晓华, 林贤郁.中国统计年鉴[M].北京:中国统计出版社, 2004:1146-1147.

[2]PAN YX, ZHU J, DU FC, et al.Blood pressure and prevalence of hypertension among populations in 12 urban and rural areas of Jiangsu Province, China[J].Jiangsu Med J, 1996, 22 (4) :245-247. (in Chinese) 潘云香, 朱杰, 杜福昌, 等.江苏12城乡人群血压水平及高血压患病率分布[J].江苏医药, 1996, 22 (4) :245-247.

[3]XIONG FB, YANG TY, XU K.Relationship of Child-Pugh classification with serum cholinesterase and albumin in patients with liver cirrhosis[J].Jiangxi Med J, 2004, 39 (1) :12-13. (in Chinese) 熊锋宝, 杨铁一, 徐铿.肝硬化患者Child-Pugh分级与血清胆碱酯酶及白蛋白相互关系的探讨[J].江西医药, 2004, 39 (1) :12-13.

[4]BI HJ, WANG J, CHEN JM.Expression of CXCR1, CXCR2 and the correlation to loads of HBV in the peripheral blord of liver cirrhosis[J].Chin J Immunol, 2013, 29 (10) :1054-1058. (in Chinese) 毕惠娟, 王健, 陈建民.肝硬化患者外周血CXCR1、CXCR2表达及其与HBV载量相关性[J].中国免疫学杂志, 2013, 29 (10) :1054-1058.

[5]LEE KC, YANG YY, WANG YW, et al.Increased plasma malondialdehyde in patients with viral cirrhosis and its relat ionships to plasma nitric oxide, endotoxin, and portal pressure[J].Dig Dis Sci, 2010, 55 (7) :2077-2085.

[6]PAPADOPOULOS N, SOULTATI A, GORITSAS C, et al.Nitric oxide, Ammonia, and CRP levels in cirrhotic patients with hepatic encephalopathy:is there a connection[J].J Clin Gastroenterol, 2010, 44 (10) :713-719.

[7]AFZELIUS P, BAZEGHI N, BIE P, et al.Circulating nitric oxide products do not solely reflect nitric oxide release in cirrhosis and portal hypertension[J].Liver Int, 2011, 31 (9) :1381-1387.

[8]WANG JY.Evaluation of guidelines for the management of cirrhotic ascites[J].Chin J Pract Intern Med, 2007, 27 (8) :563-565. (in Chinese) 王吉耀.肝硬化腹水诊治指南评价[J].中国实用内科杂志, 2007, 27 (8) :563-565.

[9]LIU LS.2010 Chinese guidelines for the management of hypertension[J].Chin J Hypertension, 2011, 19 (8) :701-743. (in Chinese) 刘力生.中国高血压防治指南2010[J].中华高血压杂志, 2011, 19 (8) :701-743.

[10]SUN XM.Effect of cognitive-behavioral intervention in patients with decompensated liver cirrhosis[J].Chin Gen Pract Nurs, 2012, 10 (24) :2231-2232. (in Chinese) 孙秀梅.认知行为干预在肝硬化病人失代偿期的效果观察[J].全科护理, 2012, 10 (24) :2231-2232.

[11]RAO ZX, TAN HQ, YANG ZY.Effect of psychological intervention in treatment of cardiovascular diseases[J].Chin Foreign Med Res, 2011, 9 (17) :119-120. (in Chinese) 饶作晓, 谭华清, 杨志远.心血管疾病患者治疗中的心理干预探讨[J].中外医学研究, 2011, 9 (17) :119-120.

[12]XU W, YANG CX, SONG YY.Effect of psychological intervention on patients with liver cirrhosis[J].Mod Clin Nurs, 2009, 8 (3) :23-25. (in Chinese) 许伟, 杨昌霞, 宋艳燕.心理干预对肝硬化患者的影响[J].现代临床护理, 2009, 8 (3) :23-25.

[13]YE LC, ZHANG QY.Research advances in mechanism of visceral angiectasis in portal hypertension[J].Int J Surg, 2006, 33 (1) :7-11. (in Chinese) 叶乐驰, 张启瑜.门静脉高压症内脏血管扩张机制的研究进展[J].国际外科学杂志, 2006, 33 (1) :7-11.

[14]HUANG CM, LI YY.Epidemiology of non-alcoholic fatty liver disease[J].Mod Digest Inte, 2009, 14 (4) :233-237. (in Chinese) 黄春明, 李瑜元.非酒精性脂肪肝的流行病学[J].现代消化及介入诊疗, 2009, 14 (4) :233-237.

[15]CHEN W, YANG C, DENG CL, et al.Changes in ADM, NO, and ET-1 levels and their significance in patients with cirrhotic portal hypertension[J].Mod Med Health, 2007, 3 (1) :6-8. (in Chinese) 陈文, 杨春, 邓存良, 等.肝硬化门静脉高压患者ADM、NO、ET-1浓度的改变及意义[J].现代医药卫生, 2007, 3 (1) :6-8.

[16]KONG M, DING QE, QIAN BY, et al.Changes in serum leptin and TNF-αand their clinical significance in patients with liver cirrhosis[J].Chin J Gen Prac, 2010, 8 (6) :771-772. (in Chinese) 孔梅, 丁秋蛾, 钱白音, 等.肝硬化患者血清瘦素、TNF-α的变化及其临床意义[J].中华全科医学, 2010, 8 (6) :771-772.

[17]PETER J, FREY O, STALLMACH A, et al.Attenuated antigenspecific T cell responses in cirrhosis are accompanied by elevated serum interleukin-10 levels and down-regulation of HLA-DR on monocytes[J].BMC Gastroenterol, 2013, 13:37.

[18]WANG J, GAO JX, BAI YZ, et al.Clinical study on serum cholinesterase in patients with liver cirrhosis[J].Chin J Lab Med, 2005, 28 (1) :68. (in Chinese) 王静, 高锦孝, 白永泽, 等.肝硬化患者血清胆碱酯酶临床研究[J].中华检验医学杂志, 2005, 28 (1) :68.

[19]VONDROKOVD, MLEKF, OST'A'DAL P, et al.New biomarkers and heart failure[J].Cor et Vasa, 2013, 55 (4) :e345-e354.

[20]SIEBER CC, GROSZMANN RJ.In vitro hypocreactivity to methoxamine in portal hypertensive rats:reversal by nitric oxide blockade[J].Am J Physiol 1992, 262 (6Pt1) :g996-g1001.

[21]WANG LJ.Clinical significance of serum NOS, NO, and TNF-αin patients with hepatic cirrhosis[J].Med J Communicat, 2001, 15 (6) :636-637. (in Chinese) 王陆军.肝炎肝硬化患者血清NOS、NO及TNF-α检测的临床意义[J].交通医学, 2001, 15 (6) :636-637.

施引文献

资源附件(0)

访问统计