【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(fā)生和發(fā)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(yī)學, 2011, 26(7): 1043-1045. doi: 復制
| 1. | 張崴, 鄔麗紅, 劉曉梅. 肝硬化患者血漿降鈣素原、內皮素-1與食管靜脈曲張的關系[J]. 臨床肝膽病雜志, 2004, 20(4): 238-239. |
| 2. | Brain SD, Grant AD. Vascular actions of calcitonin generelated peptide and adrenomedullin[J]. Physiot Rev, 2004, 84(3): 903. |
| 3. | Ikeda Y, Takami H. Calcitonin gene-related peptide (CGRP)[J]. Nippon Rinsho, 2010, 68(7): 328-330. |
| 4. | 中華醫(yī)學會消化內鏡學會. 食管胃底靜脈曲張內鏡下診斷和治療規(guī)范試行方案[J]. 中華消化內鏡雜志, 2000, 17(4): 198-199. |
| 5. | 倪振民, 王振綱. 降鈣素基因相關肽[J]. 中國藥通學通報, 1990, 6(5): 274-279. |
| 6. | Li D, Li NS, Chen QQ, et al. Calcitonin gene-related peptide-mediated cardioprotection of postconditioning in isolated rat hearts[J]. Regul Pept, 2008, 147(1-3): 4-8. |
| 7. | Luo D, Zhang YW, Peng WJ, et al. Transient receptor potential vanilloid 1-mediated expression and secretion of endothelial cell-derived calcitonin gene-related peptide[J]. Regul Pept, 2008, 150(1-3): 66-72. |
| 8. | 魏萬昆. 肝硬化門脈高壓癥患者血漿降鈣素基因相關肽檢測的臨床意義[J]. 國際檢驗醫(yī)學雜志, 2009, 30(8): 758-759. |
| 9. | Bailey DM, Taudorf S, Berg RM, et al. Transcerebral exchange kinetics of nitrite and calcitonin gene-related peptide in acute mountain sickness: evidence against trigeminovascular activation?[J]. Stroke, 2009, 40(6): 2205-2208. |
| 10. | Henriksen JH, Schifter S, Moller S, et al. Increased circulating calcitonin in cirrhosis. Relation to severity of disease and calcitonin gene-related peptide[J]. Metabolism 2000, 49(1): 47-52. |
| 11. | 薛林云, 何松, 梅浙川, 等. 肝硬化食管靜脈曲張?zhí)自g前后降鈣素基因相關肽及內皮素水平的觀察[J]. 重慶醫(yī)科大學學報, 2010, 35(2): 234-237. |
| 12. | 單成祥, 楊寧, 杭建飛, 等. 肝硬化食管靜脈曲張破裂出血危險因素的Meta分析[J]. 第二軍醫(yī)大學學報, 2007, 28(8): 888-893. |
- 1. 張崴, 鄔麗紅, 劉曉梅. 肝硬化患者血漿降鈣素原、內皮素-1與食管靜脈曲張的關系[J]. 臨床肝膽病雜志, 2004, 20(4): 238-239.
- 2. Brain SD, Grant AD. Vascular actions of calcitonin generelated peptide and adrenomedullin[J]. Physiot Rev, 2004, 84(3): 903.
- 3. Ikeda Y, Takami H. Calcitonin gene-related peptide (CGRP)[J]. Nippon Rinsho, 2010, 68(7): 328-330.
- 4. 中華醫(yī)學會消化內鏡學會. 食管胃底靜脈曲張內鏡下診斷和治療規(guī)范試行方案[J]. 中華消化內鏡雜志, 2000, 17(4): 198-199.
- 5. 倪振民, 王振綱. 降鈣素基因相關肽[J]. 中國藥通學通報, 1990, 6(5): 274-279.
- 6. Li D, Li NS, Chen QQ, et al. Calcitonin gene-related peptide-mediated cardioprotection of postconditioning in isolated rat hearts[J]. Regul Pept, 2008, 147(1-3): 4-8.
- 7. Luo D, Zhang YW, Peng WJ, et al. Transient receptor potential vanilloid 1-mediated expression and secretion of endothelial cell-derived calcitonin gene-related peptide[J]. Regul Pept, 2008, 150(1-3): 66-72.
- 8. 魏萬昆. 肝硬化門脈高壓癥患者血漿降鈣素基因相關肽檢測的臨床意義[J]. 國際檢驗醫(yī)學雜志, 2009, 30(8): 758-759.
- 9. Bailey DM, Taudorf S, Berg RM, et al. Transcerebral exchange kinetics of nitrite and calcitonin gene-related peptide in acute mountain sickness: evidence against trigeminovascular activation?[J]. Stroke, 2009, 40(6): 2205-2208.
- 10. Henriksen JH, Schifter S, Moller S, et al. Increased circulating calcitonin in cirrhosis. Relation to severity of disease and calcitonin gene-related peptide[J]. Metabolism 2000, 49(1): 47-52.
- 11. 薛林云, 何松, 梅浙川, 等. 肝硬化食管靜脈曲張?zhí)自g前后降鈣素基因相關肽及內皮素水平的觀察[J]. 重慶醫(yī)科大學學報, 2010, 35(2): 234-237.
- 12. 單成祥, 楊寧, 杭建飛, 等. 肝硬化食管靜脈曲張破裂出血危險因素的Meta分析[J]. 第二軍醫(yī)大學學報, 2007, 28(8): 888-893.