摘要
目的研究采用腹水浓缩回输联合抗感染治疗失代偿期乙型肝炎肝硬化患者的疗效。方法2018年10月~2020年10月我院收治的失代偿期乙型肝炎肝硬化患者140例,采用随机数字表法将患者分为对照组70例和观察组70例,分别给予头孢哌酮钠/舒巴坦钠静脉滴注治疗或在此基础上给予腹水浓缩回输治疗,两组均治疗观察2 w。采用放射免疫法检测血清内皮素-1(ET-1)、血浆肾素活性(PRA),采用化学发光法检测血清血管紧张素Ⅱ(AngⅡ)和醛固酮(ALD),采用ELISA法检测血清白细胞介素-6(IL-6)、IL-8和IL-10,采用显色法检测血清内毒素(LPS),采用硝酸盐还原酶法检测血清一氧化氮(NO)。结果在治疗2 w末,观察组总有效率为95.7%,显著高于对照组的82.9%(P<0.05);观察组血清BUN和sCr水平分别为(5.7±1.6)mmol/L和(115.1±27.7)μmol/L,显著低于对照组【分别为(7.1±2.1)mmol/L和(132.6±31.3)μmol/L,P<0.05】;观察组血清PRA、AngⅡ和ALD水平分别为(2.9±0.9)ng/mL/h、(290.5±64.3)ng/L和(258.1±74.2)pg/mL,显著低于对照组【分别为(3.8±1.0)ng/mL/h、(320.9±75.4)ng/L和(276.5±68.4)pg/mL,P<0.05】;观察组血清LPS和ET-1分别为(0.07±0.01)EU/mL和(75.5±2.6)ng/L,显著低于对照组【分别为(0.10±0.03)EU/mL和(89.6±5.2)ng/L,P<0.05】,而血清NO水平为(69.4±4.3)μmol/L,显著高于对照组【(55.7±3.6)μmol/L,P<0.05】。结论采取腹水浓缩回输联合抗感染治疗失代偿期乙型肝炎肝硬化患者,可消退腹水,改善肾功能,可能与抑制了肾素-血管紧张素-醛固酮系统的激活,降低了血清缩血管物质有关。
Objective This study aimed to investigate the cell-free and concentrated ascites reinfusion therapy(CFCART)for treatment of patients withdecompensated liver cirrhosis(DLC).Methods 140 patients with hepatitis B-induced DLC were enrolled in our hospitalbetween October 2018 and October 2020,and they were randomly divided into control and observation group,with 70 cases in each group.The patients in the control group wasintravenously given cefoperazone sodium and sulbactam sodium,and those in the observation group received CFCART therapy.The regimen lasted for two weeks.Serum urea nitrogen(BUN),creatinine(sCr),plasma renin activity(PRA),endothelin-1(ET-1)and angiotensinogen II(Ang II),aldosterone(ALD),interleukin-6(IL-6),IL-8 and IL-10,endotoxin(LPS)and nitric oxide(NO)levels were assayed.Results At the end of two week treatment,the total efficient rate in the observation group was 95.7%,significantly higher than 82.9%(P<0.05)in the control;serumBUN and sCr levels in the observation were(5.7±1.6)mmol/L and(115.1±27.7)μmol/L,significantly lower than[(7.1±2.1)mmol/L and(132.6±31.3)μmol/L,P<0.05]in the control;serum PRA,AngⅡand ALD levels were(2.9±0.9)ng/mL/h,(290.5±64.3)ng/L and(258.1±74.2)pg/mL,all significantly lower than[(3.8±1.0)ng/mL/h,(320.9±75.4)ng/L and(276.5±68.4)pg/mL,respectively,P<0.05]in the control;serum LPS and ET-1 levels were(0.07±0.01)EU/mL and(75.5±2.6)ng/L,significantly lower than[(0.10±0.03)EU/mL and(89.6±5.2)ng/L,P<0.05],while serum NO level was(69.4±4.3)μmol/L,significantly higher than[(55.7±3.6)μmol/L,P<0.05]in the control group.Conclusion The CFCART therapy in dealing with patients with DLC could effectively improve kidney functions,which might be related to the inhibition of renin angiotensin aldosterone system.
作者
王本贤
李伟
李东生
李华
Wang Benxian;Li Wei;Li Dongsheng(Department of Gastroenterology,Traditional Chinese Medicine Hospital,Zhoukou 466000,Henan Province,China)
出处
《实用肝脏病杂志》
CAS
2022年第2期247-250,共4页
Journal of Practical Hepatology
基金
全国西学中骨干人才培训基金项目[国中医药人教函(2019)44号]。
