摘要
目的了解肝移植患者术后一周内二胺氧化酶（Diamine oxidase，DAO）的变化规律，从而来了解门静脉阻断是否是造成肝移植术后早期肠粘膜屏障功能损伤的原因，并找出child—pugh评分与DAO之间的关系。方法分别在进入手术室（入室）、门静脉阻断（简称阻断）、门静脉阻断30min（简称阻断30’）、门静脉开放（简称开放）、手术后1d-手术后7d共11个时间点取肝素抗凝血，用分光光度计法检测DAO。将62例肝患者按child—pugh评分及进入手术室所测DAO活性的低、中和高水平进行分组。结果child-pugh评分为A和B级的患者手术前DAO活性均小于5U／ml，C级的患者中只有31％手术前DAO活性小于5U／ml，两者有显著性差异；child．pugh评分为C级、DAO活性大于15U／ml的患者，DAO在相应的时间点上呈进行性降低趋势，child—pugh评分为C级、DAO活性大于5U／ml而小于15U／ml的患者，DAO在相应的时间点上呈稍微走低趋势，child—pugh评分为C级、DAO活性小于5U／ml和child—pugh评分为A和B级、DAO活性小于5U／ml的患者，DAO均在第二天出现峰值。结论门静脉阻断能造成术后早期肠粘膜的损伤；DAO变化与child—pugh评分因素有一定关联性。
Objective First of all, to investigate the change of DAO in the early postoperative liver transplantation. Secondly, to confirm whether portal vein occlusion would result in intestinal mucosa barrier impairment. Thirdly, to learn what the relationship between child-pugh score and DAO. Methods Divided 62 patients with liver transplantation into four groups according to child-pugh score and DAO activity. Collect blood plasma on the 10 respectively times and determine DAO activity by spectrophotometer. Results DAO activity was totally less than 5 U/ml among the patients with child＇s class A and B. Further more, DAO activity of only 31% patients in class C were less than 5U/ml and the difference of DAO activity was significant in the statistics. Besides, the change of DAO was decreased rapidly among patients with higher DAO activity（ 〉 15 U/ml） in class C and change pattern of DAO was decreased slightly among patients with midrange DAO activity（ 15 U/ml 〉 DAO 〉 5 U/ml） in child＇s class C. The peak value of DAO appeared a- mong patients with low DAO activity （DAO 〈5 U/ml）in child＇s class A B and class C on the second day of postoperative liver transplantation. Conclusion The occlusion of portal vein plays a part in the damage of intestine mucosa barrier. There is a correlation between DAO activity and child-pugh class.
出处
《肝胆外科杂志》
2008年第2期103-105,共3页
Journal of Hepatobiliary Surgery
