Changes of plasma endothelin-1 in liver cirrhosis and its clinical significance

Objective To investigate the plasma level of endotheline-1(ET-1) to assess its role in liver injury, portal hypertension and hepatopulmonary syndrome in cirrhotic patients. Methods With radioimmunoassay and automatic blood gas analyzer, the levels of plasma ET-1 and arterial oxygen were detected in 20 normal subjects as controls and 50 cirrhotic patients. Results The plasma ET-1 level was significantly higher in cirrhotic patients than that in the controls. Plasma ET-1 was correlated with decreased liver function and portal hypertension in cirrhotic patients. Alveolar arterial oxygen gradients (AaDpO 2) were significantly higher in cirrhotic patients than those in the controls. Partial oxygen pressure of arterial blood (PaO 2) was significantly lower in cirrhotic patients than that in the controls. Hypoxemia occurred mainly in patients with Child Pugh C, which was correlated with portal hypertension. Correlation analysis showed positive correlation between plasma ET-1 and AaDpO 2 in cirrhotics and portal hypertension patients; there was negative correlation between plasma ET-1 and PaO 2. Conclusion The plasma level of ET-1 is closely related with the severity of liver cirrhosis. It is probable that liver injury causes higher ET-1 which is important in the pathogenesis of cirrhotic portal hypertension and HPS.(Shanghai Med J, 2001,24∶612 614)