Elevated nitric oxide levels in patients with chronic liver disease and cirrhosis correlate with disease stage and parameters of hyperdynamic circulation

被引:32
作者
Arkenau, HT
Stichtenoth, DO
Frölich, JC
Manns, MP
Böker, KHW
机构
[1] Zent Krankenhaus Bremen Ost, Innere Med Klin, D-28325 Bremen, Germany
[2] Hannover Med Sch, Klin Pharmakol Abt, Hannover, Germany
[3] Hannover Med Sch, Abt Gastroenterol Hepatol & Endokrinol, Hannover, Germany
来源
ZEITSCHRIFT FUR GASTROENTEROLOGIE | 2002年 / 40卷 / 11期
关键词
liver cirrhosis; portal hypertension; nitric oxide; nitrates; renine; interleukin-6; tumour necrosis factor-alpha;
D O I
10.1055/s-2002-35413
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Chronic liver diseases are accompanied by changes in splanchnic and systemic circulation. These changes are characterised by a reduction in peripheral vascular resistance and an increased cardiac output at rest. An increased release of nitric oxide (NO) has been proposed to play a role in the pathogenesis of vasodilatation and vascular hypocontractility. This study was designed to determine the nitric oxide metabolism measured as circulating nitrate levels in serum/urine in patients with chronic liver disease and cirrhosis. The nitrate concentrations were significantly increased in advanced degrees in cirrhosis Child B and C, and normal or even reduced in patients with chronic active hepatitis and early cirrhosis. In our study the connections between the extent of portal hypertension and nitrate levels were evident. The presence of ascites as well as the the progression of oesophageal varices were associated with higher circulating nitrate levels. The connection between increased nitric oxide production and the haemodynamic sequelae of portal hypertension is also apparent in the significant correlation between plasma renin and serum nitrate levels. Circulating nitrate levels also correlated to the serum interleukin-6 levels. This study demonstrated that the increased nitric oxide metabolism is associated with the haemodynamic alterations induced by portal hypertension.
引用
收藏
页码:907 / 912
页数:6
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