Plasma NO And ET Levels In Patients With Cirrhosis: Association With Esophageal Varicosity Hemorrhage

Objective To study the relationship between the plasma NO and ET levels of and esophagus varicosity hemorrhage in cirrhosis patients and to investigate the possibility of estimating hemorrhage by measuring the plasma NO and ET levels. Methods Fourteen cirrhotic patients with esophageal varicosity hemorrhage, 15 cirrhotic patients without hemorrhage and 15 healthy controls were recruited. The plasma NO level was examined by the calorimetric assay, and the plasma ET level by the radio immunoassay (RIA). Portal vessel diameter (PVD), Spleen vessel diameter (SVD) and right portal blood velocity (RPBV) were measured by the Color Doppler. Esophagus vessel diameter (EVD) and red color ( "R-C" ) symptom were determined by the endoscope. The levels of NO and ET were compared among these three groups. The relationships among NO and ET levels and PVD, SVD, RPBV, EVD and R-C signs were evaluated. Results Compared to the normal controls, the plasma NO and ET levels were significantly higher in cirrhotic patients with hemorrhage than those without hemorrhage (p<0.01). There was a significant and positive correlation between the plasma NO and ET levels, as well as among the levels of NO, ET and PVD, SVD and EVD (p<0.05-p<0.01). A significantly negative correlation was observed among the plasma levels of NO, ET and RPBV (p<0.01). The levels of NO and ET were significantly higher in patients with PVD> 1.3cm than those with PVD 1.3cm (p< 0.01), in patients with EVD>mm than those with EVD 5mm (p<0.01), and in patients with "R-C" signs than those without "R-C" signs (p<0.01), respectively. Conclusion There may exist an association between the plasma levels of NO, ET and esophageal varicosity hemorrhage in patients with cirrhosis, suggesting that the plasmalevels of NO and ET may be predicative parameters for esophageal varicosity hemorrhage in cirrhotic patients.