الفهرس 
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Abstract
Chronic liver disease including cirrhosis is caused by various etiologies, such as hepatitis viruses and alcohol. Through these stimulation and inflammatory injury, intrahepatic fibrotic change begins and is followed by intrahepatic vascular change and angiogenesis and portal hypertension development.
Portal hypertension is a hemodynamic syndrome mostly caused by liver cirrhosis in the Western Countries. It causes a series of alterations responsible for the onset of complications of cirrhosis, such as gastrointestinal hemorrhage, ascites, portal-systemic encephalopathy, hepato-renal syndrome, hepato pulmonary syndrome, spontaneous bacterial peritonitis. Hemodynamic alterations of portal hypertension do not only involve portal–hepatic hemodynamics but splanchnic and systemic circulation too.
Apelin is a peptide isolated from bovine stomach extracts act as an endogenous ligand for the previously orphaned G protein-coupled receptors. (APJ) receptor now is a putative receptor protein related to the type 1 angiotensin receptor.
The expression of endogenous apelin/APJ signaling is associated with the development of portal hypertension, and contributes to the formation of portosystemic collateral blood vessels and splanchnic neovascularization, presenting a potential novel therapeutic target for portal hypertension and other diseases in which pathological neoangiogenesis is involved.
Aim of this work is to study the relation between serum apelin and portal hemodynamics in patients with liver cirrhosis.
Summary
This study was carried out on 60 patients with cirrhosis of different etiologies and all patients were subjected to ultrasonographic studies for portal hypertension and measurement of serum apelin level. In addition, 20 healthy volunteers were enrolled in the study as a control group (age and sex matched).We excluded patients with hypertension, diabetes mellitus, cardiopulmonary disorders and renal disorders. Also, smokers and alcoholics and patients with hepatocellular carcinoma were excluded from the study
In our study, the main etiology of liver cirrhosis was HCV infection which followed by HBV infection and autoimmune hepatitis.
In the present study the mean value of serum apelin was significantly higher in cirrhotic patients than the control group.
Also, our study showed positive correlation between serum apelin and AST/PLT index.
In the present study, at a cutoff point of 2550 ng/dl for serum apelin, the sensitivity of serum apelin to predict portal hypertension was 89%, specificity was 65% and accuracy was 81%.