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SİROZLU HASTALARDA PLAZMA NİTRİK OKSİT DÜZEYLERİ

Plazma mtrıc oxide levels in cirrhotic patients

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 1999

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
NO İs an important regülatör of a variety of physiological funetions and synthesised from L-arginin. Patients and experimental animals with cirrhosis characteristİcally have hyperperdynamic circulation which characterized by low arterial blood pressure, high cardiac output and iow peripheral resistance. It has been known for a Iong time tbat this hyperdynamic circulation is accompained by a hyoreactivity to diffe-rent vasopressors. Systemİc and especially splanchnic vasodilalation are crucial contributors to the hemodynamic derangement in ehronic porlal hypertension. In our study we aimed to examine any relatİonship between plasma nitrat/nitrit levels and co-urse of the cirrhosis. The study group was consisted of 28 patients (mean age, 52±IO years) and control group was 14 patients (mean age, 45±13 years). Plasma nitrat/nitrit levels were 75.88+21.24 umol/I in patients with cirrhosis and 50.75iI4.35 unıoI/T in controls (p<0.0001). Plasma nitrat/nitrit levels were 83.74±24.06 pmol/I in cirrhotic patients with ascites (n-15) and 66.81+13.7 pmol/I in cirrhotic patients withouth ascites (n=I3) (p=0.033). There was mo-derate a negative correiatiön between systemic aıterial tension and plasma nitrat/nitrit levels (r=0.62, p<0.000[). The results of this study supports the concept that ther is inereased pro-ducüon of nitric oxide in patients with cirrhosis. We conelude that inereased produetion of NO contributes to systemic arteria! hypotension and development of ascites in patients \vith cirrhosis.
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Abstract (Original Language): 
Nitrik oksid (NO) sirozlu hastalardaki hiperdinamik dolaşım ve perİferik vazodilatasy ondan sorumlu tutulan medyatörierden biridir. NO damar eııdotel hücrelerinden salınan güçlü bir va-zodilatatör maddedir. Hipotansiyon, düşük sistemik vasküler direnç ve vazokonstriktör maddelere karşı azalmış cevap portal hipertansiyondaki hiperdinamik dolaşımın ana özellikleridir ve sirozun klinik komplikasyonlan için ciddi bir tetikleyici faktördür. Amacımız sirozlu hastalarda hastalıkla ilgili patofizyolojik süreçlerle NO düzeylerinin klinik ilişkisini araştırmaktır. Hastalar (n=28) 52±10 yaşında, kontrol grubu ise (n-14) 45±13 yaşındaydı (p>0.05). Hasta grubunun plazma nitrat/nitrit düzeyi 75.88±21.24 umol/1 iken kontrol grubunun 50.75+14.35 pmol/1 bulundu (p<0.0001). Asiti olan hastaların ortalama plazma nitrat/nitrit düzeyi (n-15) 83.74+24.06 umol/I iken asiti bulunmayan hastaların (n=13) 66.81±13.17 umol/I bulundu (p=0.033). Hastaların ortalama kan basıncı ile plazma nitrat/nitrit düzeyleri arasında orta derecede, anlamlı, negatif bir korelasyon saptandı (r=0.62, p<0.0001). Sonuç olarak, karaciğer sirozlu hastalarda vazodilatatör bir madde olan NO düzeyleri artmaktadır. NO düzeylerindeki bu artış sirozlu hastalarda sık rastlanan sistemik hipotansiyon ve asit gelişimine katkıda bulunabilir.
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  • Turkish

REFERENCES

References: 

1. Atucha MN, Shah V, Cardena GG, Sessa EW: Role of endothelium in the abnormal response of mesenteric ves-sels in rat with portai hypcrtension and liver cirrhosis. Gastroenterology ] 11:1627 (1996).
2. Bemardi M, Trevİsani F: Systemic and regional hemody-namics in preascitic cirrhosis. J Hepatol 27:588 (1997).
3. Caslro A, Jimenez W, Claria J, Ros J, Martinez JM, Bosch M, Arroyo V, Piuials J, Rivera F, Rodes J: Impai-red responsiveness to angiotensin 2 in e.xperimental cirrhosis role of nitric oxide. Hepotology 18:367 (1993).
4. Chin Dusting J, Jennings G, Dudley F: Effect of fluoro-quinolone on the enhanced nilric oxide-induced periphe-ral vasodilalion seerı in cirrhosis. Ann Int Med 127:985 (1997).
5. Cİaria J, Jimenez_W, Ros J, Asbert M, Castro A, Arrayo V, Rivera F, Rodes J: Pathogenesis og arteria! hypotensİ-on in cirrhotic rats with ascites: a role of endogenous nitric oxide (NO). Hepatology 15:343 (1992).
6. Grisham MB, Johnson GG, Gautreaux MD, Berg RD: Measurement of nilraLe and nitrite in exfıcelular fluids: a window to systemic nitric oxidc metabolisrn. Methods: A comparison of methods in enzymolog 7:84 (1995).
7. Groszmann RJ: Hyperdynamic state n ehronic liver dise-ases. J Hepatol I7:S38 (1993).
8. Gurner C, Soriano G, Tomas A, Bulbcna O, Novella MT, Balanzo J, Vilarde] F, Maurella M, Moncada S: inereased serum nilrite and nitrate leveis in patients wi!h cirrhosis: relationship to endotoxcmia. Hepatology 18:1139 (1993).
9. Henriksen JH: Systemic haemodynamic alteration in he-patic cirrhosis. Eur J Gaslroenterol Hepatol 3:705 (1991).
10. Loscalzo I; Nitric oxide: biologic and medical impiicati-ons, In: Fauci SA, Braunwald E, eds. Harrison's Princip-les of İntern Medicine 14th edilion. Vol.l. McGraw-Hilî, 442-4(1998).
11. Mac Gilehrist AJ.Sıımroer D, Reid JL: İmpaired pressor reactivity in cirrhosis; evidence for a peripheral vascular defect. Hepatology 13:689 (1991).
12. Martin PY, Gines P, Schrier RW: Nİtric oxide as a medi-alor of mediator of hemodynamic abnormaüties and so-dİum and water relention in cirrhosis. N Eng J Med 339:533 (1998).
13. Martin, P, Xu D, Miedenberger M, VVeİgert A, Tsai P, St John J, Gİnes P, Schrier R: Upregulation of endothelial constİtuve NOS: a majör roleİn the inereased NO pro-duetion in cirrhotic rats. Anı J Physiol 270: F494 (1996).
14. Morelas-Ruiz M, Jimenez W, Perez-Sala D et al: inereased nitric oxide syntfıase expression in arLeriai vessels of Gİrrhotİe rats with ascites. Hepatology 24:1481 (1996). "
15. Niederberger M, Martin PY, Gines P el al: Normalizati-on of nitric oxide produetion corrects arlerial vasodilata-tion and hypcrdynamic circıılalion in cirrhotic rais Gast-
• reenterology 109:1624(1992).
16. Podolsky KD, Issclbacher KJ: Cirrhosis and alcoholic liver disease. In: Fauci SA, Brau«wald E, eds. Harrison's Principles of İntemal Medicine 14th edition. Vol.2. McGraw-Hill 1704 (1998).
17. Schrier RW, Arroya V, Bernardi M, Epstein M, Hcnrİk-sen, JH, Rodes J: Periphcrai arlerial vasodilalion hypot-hesis: a proposal for the iniliation of renal sodiıım and waler retention in cirrhosis. Hepatology 8:1151 (1988).
18. Sherlock S: Vasodilalion associaled wilh hepatocellular disease: relation to functional organ failure. Gut 31:365 (1990).
19. Sieber CC, Lopez-Talavera JC, Grozman RJ: Role of nilric oxide in the in vitro splanchnic vascular hyporeac-tivity in ascitis cirrhotie rats. Gastroenterology 104:1750 (1993).
20. Vallencc P, Moncada S: Hyperdynamic circulation in cirrhosis: a role for nitric oxide. Lancel 337:776 (1991).
21. VVong F, Liu P, Tobe S, Morali G, Blendis G: Central blood volume in cirrhosis: measurement wilh radionucli-de angiography. Hepatology 19:312 (1994).

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