【摘要】：肝肺綜合征(hepatopulmonary syndrome, HPS)是在慢性肝病和／或門脈高壓的基礎(chǔ)上出現(xiàn)肺內(nèi)血管異常擴(kuò)張,氣體交換障礙,動脈血氧合作用異常。目前臨床上缺乏明確的診斷標(biāo)準(zhǔn),但在臨床上較認(rèn)可的標(biāo)準(zhǔn)有以下幾點(diǎn)：1、慢性肝臟病變的基礎(chǔ)；2、患者由臥位轉(zhuǎn)為直立位血氧分壓下降,在直立位時(shí)動脈氧分壓降低約10%以上；3、CT薄層掃描發(fā)現(xiàn)肝肺綜合癥患者右下肺動脈支氣管比例為2：1,而正常為1.2：1。大約有1/3-2/3的肝硬化患者可出現(xiàn)動脈氧分壓下降,10-20%的病人出現(xiàn)肝肺綜合征。90%的肝肺綜合征患者,在早期取平臥時(shí)所測得的血?dú)夥治鲅醴謮和钦５?但在直立位時(shí)動脈氧分壓降低約10%以上,即發(fā)生所謂的直立性低氧血癥。同時(shí)許多患者主訴從平臥到直立體位出現(xiàn)呼吸困難。平臥后可以緩解。國內(nèi)外多數(shù)實(shí)驗(yàn)認(rèn)為本病的發(fā)生機(jī)制與體內(nèi)NO生成增加有關(guān)。本實(shí)驗(yàn)結(jié)扎雌性大鼠膽總管,使之發(fā)生膽汁淤積性肝硬化,通過肝病理檢查證實(shí)大鼠肝硬化模型建立,對肝硬化大鼠取靜脈血測NO-2/NO-3以及動脈血?dú)夥治鲎C明肝肺綜合征模型的成功建立及NO與肝肺綜合征的關(guān)系,從而為后期的藥物實(shí)驗(yàn)奠定基礎(chǔ),最終發(fā)現(xiàn)新的治療肝肺綜合征的藥物。
[Abstract]:On the basis of chronic liver disease and / or portal hypertension, hepatopulmonary syndrome (hepatopulmonary syndrome, HPS) is characterized by abnormal dilation of pulmonary blood vessels, gas exchange disorder and abnormal arterial and blood oxygenation. At present, there is no definite diagnostic standard in clinic, but the more recognized criteria are as follows: (1) the basis of chronic liver disease; (2) the partial pressure of blood oxygen decreased from lying position to orthostatic position, and the partial pressure of arterial oxygen decreased by more than 10% in upright position; 3. The ratio of right inferior pulmonary artery bronchus to right inferior pulmonary artery bronchus in patients with hepatopulmonary syndrome was 2? 1, while that in normal patients was 1.2? There are about 1-3-2-3 cirrhosis patients with decreased arterial oxygen pressure, 10-20% of patients with hepatopulmonary syndrome, 90% of patients with hepatopulmonary syndrome, The oxygen partial pressure measured during early recumbent was usually normal, but the arterial oxygen partial pressure decreased by more than 10% at orthostatic position, that is, the so-called orthostatic hypoxemia occurred. At the same time, many patients complained of dyspnea from lying flat to upright position. It can be relieved after lying flat. Most experiments at home and abroad suggest that the pathogenesis of the disease is related to the increase of NO production in vivo. The common bile duct of female rats was ligated to cause cholestasis cirrhosis. The successful establishment of the model of hepatopulmonary syndrome and the relationship between NO and hepatopulmonary syndrome were proved by venous blood test of NO-2/NO-3 and arterial blood gas analysis in cirrhotic rats, thus laying the foundation for the later drug experiment. A new drug for the treatment of hepatopulmonary syndrome was eventually discovered.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R-332;R575;R563

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