Plasma Nitric oxide levels in liver cirrhosis

ABSTRACT

Chronic liver diseases are often characterized by portal hypertension an important component is increased intrahepatic vascular resistance. It is now established that nitric oxide is a key factor in the hemodynamic abnormalities associated with liver cirrhosis and chronic portal hypertension. The aim of this work is to measure plasma levels of nitric oxide in patients with liver cirrhosis and portal hypertension and to find out the correlation between nitric oxide levels and stage and severity of cirrhosis and between nitric oxide levels and parameters of hyperdynamic circulation. The study included 45 patients with cirrhosis which were divided into 3 groups. The first group included 15 cirrhotic patients Child class A, the second group included 15 cirrhotic patients Child class B and the third group included 15 cirrhotic patients Child class C. A control group included 12 healthy subjects. This study showed that nitric oxide levels determined as the stable end product nitrate, measured by photometric means, are highly significantly increased among cirrhotic patients Child class A, or class B, or class C groups compared to the healthy controls [p<0.01]. Furthermore, nitric oxide levels are highly significantly increased in cirrhotic patients with ascites [Child class B or class C groups] compared to those without ascites [Child class A group] [p<0.01]. Moreover, there was significant difference of Nitric oxide between child class B and class C groups which means that Nitric Oxide level increases proportionally with the severity of cirrhosis. Also cirrhotic patients [Child class A, or class B, or class C] have highly significantly increased cardiac index [p<0.01] and decreased mean arterial pressure [p<0.01] compared to healthy controls. Moreover, there is highly significant negative correlation between nitric oxide levels and mean arterial pressure and highly significant positive correlation between nitric oxide levels and cardiac index