الفهرس 
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Abstract
Liver Cirrhosis is an end stage of chronic diffuse liver disease. It is characterized by alteration of the normal liver architecture into structurally abnormal nodules of liver cells surrounded by fibrosis. The changes must be diffuse throughout the liver. Pathologically, cirrhosis is divided into macronodular, micronodular and mixed macronodular and micronodular cirrhosis. Typically, chronic viral hepatitis produces mixed macronodular and micronodular cirrhosis, and alcohol produces micronodular cirrhosis.
Patients who present with cirrhosis related complications (for example, hepatic encephalopathy, esophageal varices bleeding and HCC) have a decreased survival rate compared with those without complications.
Serotonin is formed in the body from exogenous L- tryptophan. The process of serotonin synthesis occurs in the gastrointestinal (GI) tract, central and peripheral nervous system, and immune system cells. The GI tract is the largest source of serotonin. Approximately 90% of total serotonin is found there and is synthesized mainly in the enterochromaffin cells.
The liver plays an important part in serotonin metabolism. Hepatocytes contain enzymes maintaining the specific metabolism of some amino acids and serotonin precursors. Serotonin has vasoconstrictor effect and increases vascular wall permeability.It promotes the increase in portal pressure aggravating edema and inflammation of the liver which complicate the course of chronic hepatitis and cirrhosis of the liver, in addition to its function as a neurotransmitter and vascular active molecule, serotonin is also a mitogen for hepatocytes and promotes liver
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regeneration. Aim of this study is to assess the serotonin blood level in patients with liver cirrhosis.
The present study was conducted on 68 cases of patients with liver cirrhosis. In addition 20 apparently healthy subjects matching age and gender were selected as a control group. The patients were chosen from outpatient clinic of Menoufia University Hospital and Shebin El-Kom fever hospital during the period from January 2013 to August 2013. They include 38 male, and 30 female. All patients were subjected to thorough history taking, complete physical examination and laboratory investigations including: complete blood count, kidney function tests (Urea, Creatinine), liver function tests (AST, ALT, bilirubin (total &direct), albumin, prothrombine time), viral markers, measurement of serotonin blood level and abdominal ultra sound.
Statistical analysis of the results of the present study revealed the following points:
There was no significant difference between patients and controls as regard gender and age.
WBC is significantly higher in patients than in controls.
HB is significantly lower in patients than in controls
There was no significant different as regard PLT count between patients and controls
ALT, AST, are significantly higher in patients than in controls.
Albumin is significantly lower in patients than in controls.
PT is significantly higher in patients than in controls.
D.BIL, T.BIL are significantly higher in patients than in controls .
Urea , creatinine are significantly higher in patients than in controls
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US liver size, spleen size, P.V size are significantly higher in patients than in controls.
APRI score is significantly higher in patients than in controls.
Blood serotonin is significantly higher in patients than in controls.
Blood serotonin is significantly higher in child A than child B and C There are no significant correlations between patients’ blood serotonin and age, HB, PLT, ALT, AST, PT, INR, T.BIL, D.BIL, UREA, CREAT, liver size, and APRI score).
There is positive significant correlation between patients’ blood serotonin and albumin, WBC, spleen size, and portal vein diameter.
There are negative significant correlations between patients’ blood serotonin and Child pugh score, and MELD score.