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目的检测慢性肝病患者血清一氧化氮(NO)、诱导型一氧化氮合酶(iNOS)水平,分析作为肝细胞损伤程度分级的辅助指标。方法采用硝酸还原酶法、分光光度法与自动生化仪化学法测定60例正常对照组、35例慢性轻度乙肝、38例慢性中度乙肝、26例慢性重度乙肝、30例肝炎肝硬化和39例原发性肝癌患者血清中NO、iNOS的含量及肝功能指标,并进行相关分析。结果慢性重度乙肝组血清NO、iNOS水平>慢性中度乙肝组>肝炎肝硬化组>原发性肝癌组>慢性轻度乙肝组>正常对照组。慢性轻度乙肝组NO、iNOS水平与ALT、ALP正相关(P<0.05)、慢性中度乙肝组与STB、SDB、ALP正相关(P<0.05),与ALT呈显著正相关(P<0.01)、慢性重度乙肝组与STB、SDB、ALP、ALT呈显著正相关(P<0.01),与ALB呈负相关(P<0.05);肝炎肝硬化组及原发性肝癌组与STB、SDB、ALP呈显著正相关(P<0.01),与TBA、ALT正相关(P<0.05),与ALB显著负相关(P<0.01)。结论血清NO、iNOS水平在慢性肝炎由轻度发展到中度、重度乃至肝硬化、肝癌过程中的不同阶段存在显著差异,与肝功能指标存在相关性,可作为辅助性指标,结合其他肝功能指标作为肝细胞损伤程度的血清学分级。
Objective To detect the levels of serum nitric oxide (NO) and inducible nitric oxide synthase (iNOS) in patients with chronic liver disease, and to analyze the level of liver cell damage as an auxiliary index. Methods 60 cases of normal control group, 35 cases of chronic mild hepatitis B, 38 cases of chronic moderate hepatitis B, 26 cases of chronic severe hepatitis B, 30 cases of hepatitis cirrhosis and 39 cases of liver cirrhosis were detected by nitrate reductase method, spectrophotometry and automatic biochemical analyzer. Cases of patients with primary liver cancer serum NO, iNOS content and liver function indicators, and correlation analysis. Results Serum levels of NO and iNOS in chronic severe hepatitis B group were higher than those in chronic moderate hepatitis B group, hepatitis cirrhosis group, primary liver cancer group, chronic mild hepatitis B group, and normal control group. The level of NO and iNOS in chronic mild hepatitis B group was positively correlated with ALT and ALP (P <0.05), while the chronic moderate hepatitis B was positively correlated with STB, SDB and ALP (P <0.05) SDB, ALP and ALT were significantly correlated with chronic severe hepatitis B (P <0.01), but negatively correlated with ALB (P <0.05). The levels of STB, SDB, ALP (P <0.01), positively correlated with TBA and ALT (P <0.05), and negatively correlated with ALB (P <0.01). Conclusions Serum NO and iNOS levels are significantly different in different stages of mild to moderate, severe and even cirrhosis of liver cancer, and correlated with liver function indexes, which can be used as adjunctive markers in combination with other liver functions Indicators Serological grading as the degree of hepatocellular injury.