The First Step Study Of The Relationship Between Heme Oxygenase-carbon Monoxide System With Plasma Endothelin In Hepatic Cirrhotic With Portal Hypertension Patients

Objective: The previous study showed that disequilibrium of vasodilatation and vasoconstriction substance plays an important role in the formation and development of portal hypertension. In recent years, it has been gradually learnt that heme oxygenase– carbon monoxide system (HO-CO) with vasodilatation function and endothelin (ET) known as the most powerful intracorporal vasoconstriction activated substance, are very helpful in portal hypertension. By detecting the levels of blood COHb & plasma ET in healthy controls, patients with chronic hepatitis and patients with cirrhosis portal hypertension, we attempted to investigate the relationship between HO-CO system and ET with portal hypertension, and to find out whether or not there is any relativity between two of them. We looked forward to find a method to lower portal hypertension through the intervention of medicine to regulate blood motility.Methods: In this study 3 groups were divided: healthy control group(n=20), patients with medium or advanced chronic hepatitis (n=20, re."Nationsl Viral Hepatitis Prevention and Cure Scenario"passed by Xi'an Liver Disease Conference in 2000), and patients with cirrhosis portal hypertension(n=26, re."Cirrhosis Diagnosis Driteria"of internal medicine, sixth edition). No statistical significance on sex and age. Dual-wavelength spectrophotometry was applied to detect the blood COHb concentration to represent the level of HO-CO system, and radioimmunoassay to detect plasma ET-1 level , SPSS10.0 to analyze the results and take P<0.05 as existing statistical discrepancies.Results: 1. The HO- CO level of patients with portal hypertension(1.0285±0.5915%), is remarkably higher than that of the control group(0.495±0.215%) and the chronic hepatitis group(0.517±0.293%) (P<0.05). Besides, there is no obvious difference between the chronic hepatitis group and the control group (P>0.05).2. The ET-1 level of patients with portal hypertension(134.2708±14.9883ng/ml) is remarkably higher than that of the control group(44.6495±9.0773ng/ml) and the chronic hepatitis group(63.9035±11.9331ng/ml) (P<0.05). Besides, the ET-1 level of chronic hepatitis group is also remarkably higher than that of the control group (P<0.05).3. The HO-CO level is positively relevant with ET level of portal hypertension patients (P<0.05). The HO-CO level and plasma ET level of chronic hepatitis group show no obvious relativity.Conclusions: By the evaluation of the blood COHb level and plasma ET level of the patients with chronic hepatitis, the liver cirrhostic patients with portal hypertension and healthy controls, we may draw the conclusion as followed:1. The HO-CO system plays an important role in the portal hypertension. But it is speculated that there are no obvious relationship between the system and chronic liver fibrosis extent.2. The plasma ET-1, having a biological effect on the pathology damage to the portal hypertension, is definitely related to liver fibrosis extent.3. The HO-CO level and plasma ET-1 level of patients with portal hypertension are positively relevant. They may work in coordination to sustain the high dynamical circulation of portal hypertension, and they may show an antergic interaction effect.The results of this study may enhance the comprehension to the pathological and physiogical process of portal hypertension. Further, we will verify and perfect the study by an animal model, and hope to offer some new ways of thinking for the treatment of portal hypertension.