Study Of Correlation Between The Plasma Level Of Vasoactive Substances And The Different Clinical Features Of Portal Hypertension In Cirrhosis

Objective: to investigate the relationship between the plasma levels of vasoactivesubstance and clinical features, and the different collateral circulation of portalhypertension in cirrhosis. To investigate the effect and significance of vasoactivesubstances in the formation of collateral circulation in PHT patients.Methods: 46 patients with PHT and 10 normal controls were studied. Plasma levelsof Aâ…¡,ET-1,NO,VEGF were measured. The thickness of spleen and the insidediameter of portal vein were measured by B-mode ultrasonography .To analyze thedifferent collateral vessels in patients with portal hypertension with multislice spiralCT. The extent of esophageal varicosis was determined by electronic endoscope.Result:1,Plasma Aâ…¡,ET-1,NO,VEGF levels were significantly higher in PHT patientsthan that in normal group. In PHT patients , Plasma NO levels were significantlyhigher in bleeding group than that in non-bleeding group(t=-2.343, p=0.024), PlasmaAâ…¡levels were significantly higher in ascite group than that in non-ascite group (t=-3.110, p=0.003) .2,The concentration of plasma NO was markedly higher in PHT patients withesophageal and gastric varices than in those without esophageal and gastricvarices(t=-2.116, p=0.04). Plasma ET-1 was markedly higher in patients withesophageal and gastric varices formed by two suppliers than in those formed by one (t=-2.736, p=0.009). There is no significant difference in plasma NO,Aâ…¡,VEGF. The concentration of plasma ET-1 was markedly higher in PHT patients with paraesophageal vessels than in those without paraesophageal vessels (t=-2.42, p=0.023) .3,The concentration of plasma Aâ…¡was markedly higher in PHT patients with splenorenal shunts than in those without splenorenal shunts (t=-0.294, p=0.045). The concentration of plasma VEGF was higher in PHT patients with splenorenal and gastrorenal shunts than in those without splenorenal and gastrorenal shunts, but the difference among the groups was not statistically significant (p>0.05). There is no significant difference in plasma NO,ET-1.4,The level of plasma vasoactive substance had no correlation with the inside diameter of portal vein and the thickness of spleen.Conclusion: 1,The plasma level of vasoactive substance has certain relationship with the different clinical features of portal hypertension in cirrhosis: The level of plasma NO is markly higher in the patients with esophageal and gastric fundus varices hemorrhage than in those without bleeding. Plasma Aâ…¡levels were significantly higher in PHT patients with ascite. The change of vasoactive substances may aggravate and affect the disease progression.2,The vasoactive substance has a high correlation with the different collateral circulation in cirrhosis. Plasma ET-1 was markedly higher in patients with esophageal and gastric varices formed by two suppliers than in those formed by one. The concentration of plasma ET-1 was markedly higher in PHT patients with paraesophageal vessels than in those without paraesophageal vessels. All indicate that vasoactive substance plays an important role in the formation of collateral circulation in cirrhosis and determines the different features of collateral circulation.In a word, liver function discompensation can induce the change of vasoactive substance.The change of vasoactive substance concemtration promotes the formation of collateral circulation ,ascite ,and variceal bleeding. The study of vasoactive substance is very important to investigate the mechanism of disease progression and potential intervention measures in cirrhosis.