摘要
目的:探讨门冬氨酸鸟氨酸对肝部分切除术后缺血再灌注损伤的保护作用。方法:选取肝部分切除术患者104例(均行肝门区域血管阻断),按随机数字表法分为对照组53例和试验组51例。对照组患者给予常规保肝药物,试验组患者在对照组基础上再予门冬氨酸鸟氨酸10 g加入5%葡萄糖注射液250 ml中静脉滴注,于术前开始应用,连续用药7 d。两组患者分别于术前第1天和术后第1、4、6天清晨空腹抽外周静脉血检测肝功能并进行比较,同时对不同肝门阻断时间下两组患者术后主要转氨酶指标[丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)]的变化进行比较。结果:两组患者术中肝脏切除范围、出血量、第一肝门血管阻断时间及麻醉时间比较差异均无统计学意义(P>0.05)。与术前比较,两组患者术后肝功能指标均有不同程度的升高,差异有统计学意义(P<0.05);试验组患者术后第1、4、6天AST、ALT水平均明显低于对照组,白蛋白水平均明显高于对照组,差异有统计学意义(P<0.05);两组患者术后总胆红素水平基本接近,差异无统计学意义(P>0.05)。选择Pringle法阻断肝门,且阻断时间≥15min的患者中,对照组患者术后AST、ALT水平高于试验组,白蛋白水平低于试验组,差异有统计学意义(P<0.05)。结论:门冬氨酸鸟氨酸对肝部分切除患者可快速、有效地恢复肝功能,尤其适用于选择Pringle法阻断肝门且阻断时间较长的患者(有明显的缺血再灌注损伤)。
OBJECTIVE：To explore the protective effect of L-ornithine-L-aspartate on ischemia-reperfusion injury after partial hepatectomy. METHODS：104 patients underwent partial hepatectomy（vessel occlusion in portal fissure）were randomly divided into control group（53 cases）and trial group（51 cases）. Control group was given routine liver-protective drugs,and trial group was additionally given L-ornithine-L-aspartate 10 g added into 5% Glucose injection 250 ml intravenously before surgery,for 7 consecutive days. The fasting peripheral venous blood was collected in 2 groups on first day before surgery and first,forth and sixth day after surgery to detect liver function;the changes of main aminopherase index（ALT and AST）were compared between 2 groups at different portal fissure vessel occlusion time after surgery. RESULTS：There was no statistical significance in the difference of liver resection range,blood loss,first porta hepatis vessel occlusion time and anesthesia time in both groups during operation（P0.05）. Compared to before surgery,liver function indexes raised to different extent in 2 groups after surgery,with statistical significance（P0.05）. The levels of AST and ALT in trial group were significantly lower than in control group on first,forth and sixth day after surgery,while albumin level was significantly higher than control group,with statistical significance（P0.05）. Total bilirubin levels of both groups were approximate basically,there was no statistical significance（P0.05）. Among those patients underwent porta hepatis vessel occlusion with Pringle method and with occlude occlusion time ≥15 min,the AST and ALT level of control group was higher than those of trial group after surgery,but albumin level was below trial group,with statistical significance（P0.05）. CONCLUSIONS：L-ornithine-L-aspartate could improve liver function fast and effectively for partial hepatectomy patients,especially for the patients underwent porta hepatic vessel occlusion with Pringle method for a
出处
《中国药房》
CAS
北大核心
2015年第26期3717-3719,共3页
China Pharmacy
关键词
门冬氨酸鸟氨酸
肝部分切除术
缺血再灌注损伤
肝功能
保护作用
L-ornithine-L-aspartate
Partial hepatectomy
Ischemia-reperfusion injury
Liver function
Protective effect
