ALTERED RENAL AND PLATELET ARACHIDONIC-ACID METABOLISM IN CIRRHOSIS
ALTERED RENAL AND PLATELET ARACHIDONIC-ACID METABOLISM IN CIRRHOSIS
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DOI：
10.1016/0016-5085(86)90921-2
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发表时间：
1986-02-01
期刊：
影响因子：
29.4
通讯作者：
GENTILINI, P
中科院分区：
文献类型：
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作者：
LAFFI, G;LAVILLA, G;GENTILINI, P
前列腺素（PG）E2，PGF 2 α，6-酮-PGF 1 α，对13例无腹水组、15例有腹水肾功能正常组、5例有腹水肾功能衰竭组和14例健康对照组的血浆TXB_2和TXB_2进行检测。第2组患者的所有尿花生四烯酸代谢产物均显著增加。肾衰竭患者显示较低的PGE 2、PGF 2 α，和TXB 2值高于组2;值也低于对照组。在所有患者组中，全血凝固过程中血小板TXA 2的产生均显著降低。低剂量阿司匹林和舒林酸，两种环氧合酶抑制剂选择性地保留肾环氧合酶活性，有效地抑制血小板TXA 2的产生，而不影响尿TXB 2的排泄，从而排除血小板作为尿TXB 2的可能来源。我们的结论是，腹水和肾功能正常的患者表现出全面激活的肾脏PG系统。肾血管舒张性PGE 2和PGI 2的产生可能参与支持这些患者的肾功能。血小板合成促聚集TXA 2的减少也发生在血小板减少症患者中。这可能在肝硬化的出血倾向中起作用。
Urinary excretion rates of prostaglandin (PG) E2, PGF2.alpha., 6-keto-PGF1.alpha., and thromboxane (TX) B2 were evaluated in three groups of cirrhotic patients [without ascites (group 1, 13 cases), with ascites and normal renal function (group 2, 15 cases), and with ascites and renal failure (group 3, 5 cases)] and in 14 healthy controls. All urinary arachidonate metabolites were significantly increased in group 2 patients. Patients with renal failure showed lower PGE2, PGF2.alpha., and TXB2 values than those from group 2; PGF2.alpha. values were also lower than controls. Platelet TXA2 production during whole blood clotting was significantly reduced in all groups of patients. Administration of low-dose aspirin and sulindac, two cyclooxygenase inhibitors selectively sparing renal cyclooxygenase activity, effectively inhibited platelet TXA2 production without affecting urinary TXB2 excretion, thus ruling out platelets as a possible source of urinary TXB2. We conclude that patients with ascites and normal renal function show an overall activation of the renal PG system. Renal production of vasodilating PGE2 and PGI2 may be involved in supporting renal function in these patients. A reduced platelet synthesis of proaggregatory TXA2 also occurs in cirrhotic patients. This may play a role in the bleeding tendency of cirrhosis.