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간경변증 환자에서 말초혈액 Nitric Oxide 활성도 측정의 의의
이보한 ( Bo Han Lee ),백두산 ( Du San Baik ),윤승욱 ( Seoung Ug Yun ),신재민 ( Jae Min Shin ),김지환 ( Ji Hwan Kim ),윤세영 ( Se Young Yun ),김병하 ( Byung Ha Kim ),김석배 ( Suk Bae Kim ),신정은 ( Jeong Eun Shin ),송일한 ( Il Han 대한내과학회 2007 대한내과학회지 Vol.73 No.3
Background: Nitric Oxide (NO) induced by NO synthase is known to be associated with hyperdynamic circulation and collateralization by vascular remodeling in patients with cirrhosis. Methods: To assess the significance of peripheral NO activity in patients with cirrhosis, we measured the production of NO metabolites, nitrate and nitrite, using the nitrate/nitrite colorimetric assay with Griess reagents in the peripheral venous blood of 95 cirrhotic patients with or without clinical portal hypertension (PHT), and in the peripheral venous blood of 32 control patients without liver disease. Results: The peripheral NO activities in cirrhotic patients with clinical PHT, cirrhotic patients without clinical PHT, and non-liver disease control patients were 86.1±40.6 μmol/L, 83.5±47.2 μmol/L and 52.3±38.4 μmol/L, respectively. NO activity was significantly higher in cirrhotic patients than in non-liver disease control patients (p<0.05), while there was no significant difference of NO activity between the cirrhotic patients with or without clinical PHT. Peripheral NO activities in cirrhotic patients with Child-Pugh classification A, B, and C were 84.9±45.5 μmol/L, 81.9±53.2 μmol/L and 86.4±39.8 μmol/L, respectively; these results were not significantly different. A significant correlation of NO activity with the biochemical profiles of the serum albumin level, bilirubin level and prothrombin time were not defined. Conclusions: Peripheral NO activity was increased in cirrhotic patients, but it did not reflect the degree of clinical portal hypertension and the function of the hepatic reserve in this study. For a precise analysis of the association of NO and hyperdynamic circulation with collateralization in cirrhosis, intrahepatic or portal NO activity might be considered rather than peripheral NO activity.(Korean J Med 73:251-257, 2007)
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