학술논문

The association between clinical symptoms, laboratory findings and serum endothelin 1 concentrations, in cirrhotic patients with and without hepatopulmonary syndrome.
Document Type
Article
Source
Gastroenterology & Hepatology from Bed to Bench. Apr2012 Supplement 1, Vol. 5, pS13-S19. 7p.
Subject
*DIAGNOSIS of dyspnea
*HEPATOPULMONARY syndrome
*ACTIVE oxygen in the body
*BIOPSY
*DEMOGRAPHY
*ENDOTHELINS
*GASTROENTEROLOGY
*HEMOGLOBINS
*CIRRHOSIS of the liver
*LIVER function tests
*LYMPHOCYTES
*MEDICAL needs assessment
*PATHOLOGICAL laboratories
*PROTEINS
*ALBUMINS
*HUMAN research subjects
*CASE-control method
*PATIENT selection
*BLOOD urea nitrogen
*SYMPTOMS
*DIAGNOSIS
Language
ISSN
2008-2258
Abstract
Aim: This study evaluated the association between serum endothelin-1 level and symptoms, clinical examination, laboratory and cardio-respiratory parameters, in patients with cirrhosis compared to controls. Background: Cirrhosis is associated with significant portal, pulmonary and systemic vascular abnormities. Recent studies have suggested that endothelin -1 may have a significant role in the regulation of vascular tone. Patients and methods: In this case - control study, subjects that had been evaluated and diagnosed with biopsy-proven cirrhosis and age-matched controls with no evidence of cardio-vascular or liver disease were recruited. Review of medical records, routine laboratory investigations and cardio-respiratory investigations including echocardiography to look for evidence of hepato- pulmonary syndrome were performed. Results: 50 patients were subjects were recruited. The most common aetiology of the cirrhosis was chronic hepatitis B viral infection. 7/50 cases had evidence of the hepatopulmonary syndrome. Among the patients with evidence of the hepatopulmonary syndrome, dyspnoea (100%) and cyanosis (90%) were the most common of the symptoms and signs recorded. Pao2 and arterial-alveolar oxygen gradients were the most sensitive tests in the diagnosis of hepatopulmonary syndrome. Orthodoxy specificity was 100%. The median concentration of serum endothelin-1 in cases with hepatopulmonary syndrome was 1.06+/- 0.015 pg/ml (range 0.92 - 1.21), in cases of sub-clinical hepatopulmonary syndrome, 2.49+/- 0.08 (4.05- 0.93) in patients with cirrhosis but no. evidence of hepatopulmonary syndrome criteria 0.85+/-0.74(l.06-0.64) in controls. Conclusion: There was a significant difference in serum endothelin-1 levels between patients with cirrhosis and controls, but not between patients with cirrhosis complicated by hepatopulmonary syndrome and controls. [ABSTRACT FROM AUTHOR]