【摘要】 目的 研究降钙素基因相关肽（calcitonin gene related peptide， 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） cm H2O（1 cm H2O=0.098 kPa）。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（P lt;0.05），在轻度曲张组明显低于中度和重度曲张组（P lt;0.05），中度和重度曲张组之间差异无统计学意义（P gt;0.05）。 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 To investigate the role of calcitonin gene related peptide (CRGP) in pathogenesis of esophageal varices in portal hypertension with cirrhosis. Methods from January 2005 to August 2010, 46 patients with portal hypertension and cirrhosis at different degrees of esophageal varices were divided into mild varicose group, moderate varicose group and severe varicose group according to the severity of esophageal varices. The patients who underwent gastrointestinal surgery without liver disease were as the control. Portal vein pressure was detected by mercury during the surgery. The expression of CGRP was assayed by enzyme-linked immunosorbent assay. Results The portal pressure was (14.8±2.1), (30.5±2.5), (44.3±3.2), and (47.6±3.8) cm H2O (1 cm H2O=0.098 kPa) in the control group and the mild, moderate and severe varicose group, respectively. Those CGRP content in the portal vein was (45.4±5.4), (69.2±7.2), (93.6±8.7), and (98.2±9.4) pg/mL, respectively. CGRP content and portal vein pressure were the lowest in control group, which were significantly lower than those in the other three groups (P lt;0.05); which were also significantly lower in mild varicose group than those in the moderate and severe esophageal varices group (P lt;0.05), while no statistic difference between moderate and severe esophageal varices group was found (P lt;0.05). Conclusion CGRP plays an important role in the occurrence and development of portal hypertension with cirrhosis concurrent esophageal varices, and it may serve as a useful indicator reflecting the degree of esophageal varices.
Citation：
WANG Yi,LI Min,ZHANG Wei. The Role of Calcitonin Gene Related Peptide in Pathogenesis of Esophageal Varices in Portal Hypertension with Cirrhosis. West China Medical Journal, 2011, 26(7): 1043-1045. doi:
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| 1. |
张崴, 邬丽红, 刘晓梅. 肝硬化患者血浆降钙素原、内皮素-1与食管静脉曲张的关系[J]. 临床肝胆病杂志, 2004, 20(4): 238-239.
|
| 2. |
Brain SD, Grant AD. Vascular actions of calcitonin generelated peptide and adrenomedullin[J]. Physiot Rev, 2004, 84(3): 903.
|
| 3. |
Ikeda Y, Takami H. Calcitonin gene-related peptide (CGRP)[J]. Nippon Rinsho, 2010, 68(7): 328-330.
|
| 4. |
中华医学会消化内镜学会. 食管胃底静脉曲张内镜下诊断和治疗规范试行方案[J]. 中华消化内镜杂志, 2000, 17(4): 198-199.
|
| 5. |
倪振民, 王振纲. 降钙素基因相关肽[J]. 中国药通学通报, 1990, 6(5): 274-279.
|
| 6. |
Li D, Li NS, Chen QQ, et al. Calcitonin gene-related peptide-mediated cardioprotection of postconditioning in isolated rat hearts[J]. Regul Pept, 2008, 147(1-3): 4-8.
|
| 7. |
Luo D, Zhang YW, Peng WJ, et al. Transient receptor potential vanilloid 1-mediated expression and secretion of endothelial cell-derived calcitonin gene-related peptide[J]. Regul Pept, 2008, 150(1-3): 66-72.
|
| 8. |
魏万昆. 肝硬化门脉高压症患者血浆降钙素基因相关肽检测的临床意义[J]. 国际检验医学杂志, 2009, 30(8): 758-759.
|
| 9. |
Bailey DM, Taudorf S, Berg RM, et al. Transcerebral exchange kinetics of nitrite and calcitonin gene-related peptide in acute mountain sickness: evidence against trigeminovascular activation?[J]. Stroke, 2009, 40(6): 2205-2208.
|
| 10. |
Henriksen JH, Schifter S, Moller S, et al. Increased circulating calcitonin in cirrhosis. Relation to severity of disease and calcitonin gene-related peptide[J]. Metabolism 2000, 49(1): 47-52.
|
| 11. |
薛林云, 何松, 梅浙川, 等. 肝硬化食管静脉曲张套扎术前后降钙素基因相关肽及内皮素水平的观察[J]. 重庆医科大学学报, 2010, 35(2): 234-237.
|
| 12. |
单成祥, 杨宁, 杭建飞, 等. 肝硬化食管静脉曲张破裂出血危险因素的Meta分析[J]. 第二军医大学学报, 2007, 28(8): 888-893.
|
- 1. 张崴, 邬丽红, 刘晓梅. 肝硬化患者血浆降钙素原、内皮素-1与食管静脉曲张的关系[J]. 临床肝胆病杂志, 2004, 20(4): 238-239.
- 2. Brain SD, Grant AD. Vascular actions of calcitonin generelated peptide and adrenomedullin[J]. Physiot Rev, 2004, 84(3): 903.
- 3. Ikeda Y, Takami H. Calcitonin gene-related peptide (CGRP)[J]. Nippon Rinsho, 2010, 68(7): 328-330.
- 4. 中华医学会消化内镜学会. 食管胃底静脉曲张内镜下诊断和治疗规范试行方案[J]. 中华消化内镜杂志, 2000, 17(4): 198-199.
- 5. 倪振民, 王振纲. 降钙素基因相关肽[J]. 中国药通学通报, 1990, 6(5): 274-279.
- 6. Li D, Li NS, Chen QQ, et al. Calcitonin gene-related peptide-mediated cardioprotection of postconditioning in isolated rat hearts[J]. Regul Pept, 2008, 147(1-3): 4-8.
- 7. Luo D, Zhang YW, Peng WJ, et al. Transient receptor potential vanilloid 1-mediated expression and secretion of endothelial cell-derived calcitonin gene-related peptide[J]. Regul Pept, 2008, 150(1-3): 66-72.
- 8. 魏万昆. 肝硬化门脉高压症患者血浆降钙素基因相关肽检测的临床意义[J]. 国际检验医学杂志, 2009, 30(8): 758-759.
- 9. Bailey DM, Taudorf S, Berg RM, et al. Transcerebral exchange kinetics of nitrite and calcitonin gene-related peptide in acute mountain sickness: evidence against trigeminovascular activation?[J]. Stroke, 2009, 40(6): 2205-2208.
- 10. Henriksen JH, Schifter S, Moller S, et al. Increased circulating calcitonin in cirrhosis. Relation to severity of disease and calcitonin gene-related peptide[J]. Metabolism 2000, 49(1): 47-52.
- 11. 薛林云, 何松, 梅浙川, 等. 肝硬化食管静脉曲张套扎术前后降钙素基因相关肽及内皮素水平的观察[J]. 重庆医科大学学报, 2010, 35(2): 234-237.
- 12. 单成祥, 杨宁, 杭建飞, 等. 肝硬化食管静脉曲张破裂出血危险因素的Meta分析[J]. 第二军医大学学报, 2007, 28(8): 888-893.
