降钙素基因相关肽在肝硬化门静脉高压症食管下段胃底静脉曲张中的作用

【】　目的　研究降钙素基因相关肽（calcitoningenerelatedpeptide，CRGP）在肝硬化门静脉高压症患者食管下段胃底静脉曲张中的作用。　方法　以2005年1月－2010年8月46例肝硬化门静脉高压症不同程度食管下段胃底静脉曲张患者作为研究对象，并按食管下段胃底静脉曲张严重程度分为轻度曲张组、中度曲张组、重度曲张组，以30例行胃肠疾病手术无肝病患者作为对照。术中水柱法测定门静脉压力；酶联免疫吸附法测定门静脉血中CGRP含量。　结果　对照组及轻、中、重度曲张组门静脉压力分别为（14.8±2.1）、（30.5±2.5）、（44.3±3.2）、（47.6±3.8）cmH2O（1cmH2O=0.098kPa）。门静脉血中CGRP的含量分别为（45.4±5.4）、（69.2±7.2）、（93.6±8.7）、（98.2±9.4）pg/mL。对照组门静脉压力及CGRP含量明显低于其他3组（P0.05）。　结论　CRGP在肝硬化门静脉高压症食管下段胃底静脉曲张的发生和发展中起重要作用，CGRP可作为反映食管静脉曲张程度的一种有用指标。【Abstract】　Objective　Toinvestigatetheroleofcalcitoningenerelatedpeptide(CRGP)inpathogenesisofesophagealvaricesinportalhypertensionwithcirrhosis.　Methods　fromJanuary2005toAugust2010,46patientswithportalhypertensionandcirrhosisatdifferentdegreesofesophagealvaricesweredividedintomildvaricosegroup,moderatevaricosegroupandseverevaricosegroupaccordingtotheseverityofesophagealvarices.Thepatientswhounderwentgastrointestinalsurgerywithoutliverdiseasewereasthecontrol.Portalveinpressurewasdetectedbymercuryduringthesurgery.TheexpressionofCGRPwasassayedbyenzyme-linkedimmunosorbentassay.　Results　Theportalpressurewas(14.8±2.1),(30.5±2.5),(44.3±3.2),and(47.6±3.8)cmH2O(1cmH2O=0.098kPa)inthecontrolgroupandthemild,moderateandseverevaricosegroup,respectively.ThoseCGRPcontentintheportalveinwas(45.4±5.4),(69.2±7.2),(93.6±8.7),and(98.2±9.4)pg/mL,respectively.CGRPcontentandportalveinpressurewerethelowestincontrolgroup,whichweresignificantlylowerthanthoseintheotherthreegroups(P<0.05);whichwerealsosignificantlylowerinmildvaricosegroupthanthoseinthemoderateandsevereesophagealvaricesgroup(P<0.05),whilenostatisticdifferencebetweenmoderateandsevereesophagealvaricesgroupwasfound(P<0.05).　Conclusion　CGRPplaysanimportantroleintheoccurrenceanddevelopmentofportalhypertensionwithcirrhosisconcurrentesophagealvarices,anditmayserveasausefulindicatorreflectingthedegreeofesophagealvarices.