ENDOTHELIUM DYSFUNCTION IN PATIENTS WITH LIVER CIRRHOSIS

O. Balazh
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Abstract

Aim: To assess endothelial dysfunction in patients with liver cirrhosis. Material and methods: The study involved 95 patients with alcoholic liver cirrhosis. The data were subjected to analysis of variance involving the calculation of arithmetic mean value and variance (М±m), estimating the values validity according to Student’s t-test and measuring Pearson correlation coefficient for binary variables. Results: The brachial artery diameter was 0.4±0.02 mm narrower, with its blood velocity flow being 25.8±3.4 cm/s slower in the mean, in the patients with liver cirrhosis with signs of hepatic encephalopathy as compared to the control group. The maximum EDV values were recorded in the patients in Group I (7.5±1.9 %), while Group III patients displayed the lowest EDV value (5.6±1.9 %). The LC patients were found to exhibit a significant increase in the concentration of ET-1 up to 1.14±0.07 fmol/ml as opposed to 0.34±0.05 fmol/ml in the control group (р<0.01), an increase in the level of VWF by 139.4±24,8 % as compared to the control group (р<0.01) and D-dimer by a factor of 6.8. Conclusions: The patients with liver cirrhosis were found to have endothelial damage, namely the dysfunction of the vasoregulating activity of vascular wall against the background of portal hypertension. Changes in the vasoactive BAS values are indicative of the damage to the vascular endothelium in LC patients with signs of HE. A steady and gradual increase or decrease in the levels of ЕТ-1, VWF, АТ ІІІ, and D-dimer may suggest the progressive character of ED in the LC patients.
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肝硬化患者内皮功能障碍
目的:探讨肝硬化患者的内皮功能障碍。材料与方法:本研究纳入95例酒精性肝硬化患者。对数据进行方差分析,计算算术平均值和方差(М±m),根据Student 's t检验估计值的效度,并测量二元变量的Pearson相关系数。结果:肝硬化伴肝性脑病患者臂动脉直径比对照组窄0.4±0.02 mm,血流速度平均慢25.8±3.4 cm/s。组患者EDV值最高(7.5±1.9%),组患者EDV值最低(5.6±1.9%)。LC患者的ET-1浓度为1.14±0.07 fmol/ml,而对照组为0.34±0.05 fmol/ml (p <0.01), VWF水平为139.4±24.8% (p <0.01), d -二聚体水平为6.8倍。结论:肝硬化患者存在内皮损伤,即门脉高压背景下血管壁血管调节功能功能障碍。血管活性BAS值的变化提示有HE体征的LC患者血管内皮受损。ЕТ-1、VWF、АТ ІІІ和d -二聚体水平的稳定和逐渐升高或降低可能提示LC患者ED的进行性特征。
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