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乌司他丁在肝切除围手术期对肝功能的保护作用 被引量:10

Ulinastatin ameliorates liver dysfunction during perioperative period of hepatectomy in liver cancer patients
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摘要 目的探讨乌司他丁(Ulinastatin)在精准肝切除围手术期对肝功能的保护作用。方法选取行精准肝切除手术的原发性肝癌患者56例,将患者分为实验组(U组)和对照组(C组)各28例。C组给予常规药物治疗,U组在C组基础上予以乌司他丁治疗。检测两组患者围手术期肝脏功能及炎症因子变化。结果术前1d两组各检测指标差异无统计学意义(P〉0.05),术后两组各检测指标水平不同程度上升,U组术后1、3、5、7d ALT水平分别为(231±29;140±21;56±13;42±6)U/L,均低于C组(267±29;158±23;69±18;53±8)U/L;AST水平分别为(175±23;94±25;47±16;36±8)U/L,均低于C组(191±17;139±16;64±15;46±11)U/L;TBIL水平分别为(30±6;39±9;31±9:21±6)μmol/L,均低于C组(34±6;46±7;35±8;26±7)μmol/L;hs-CRP水平分别为(52±22;112±23;71±16;42±13)mg/L,均低于C组(69±23;129±25;72±15;49±15)mg/L;IL-1β水平分别为(7.8±0.9;11.1±1.5;8.9±1.6;5.6±0.9)pg/ml,均低于C组(9.2±1.3;13.0±2.1;11.14-1.4;7.3±0.8)pg/ml;IL-6水平分别为(187±30;76±25;46±15;26±8)pg/ml,均低于C组(260±36:92±16:53±11;30±8)pg/ml;TNF-α水平分别为(17±4;12.0±2.4;8.6±2.4;6.7±2.0)pg/ml,均低于c组(25±4;18.7±3.3;15.0±3.1;9.6±1.7)pg/ml,两组患者各检测指标在术后不同时间点对比,差异均有统计学意义(均P〈0.05)。结论乌司他丁对精准肝切除围手术期患者的肝功能具有保护作用. Objective To investigate the protective effect of Ulinastatin on liver function after precise hepateetomy. Methods Fifty-six patients of hepatocellular carcinoma undergoing hepatectomy were divided into Ulinastatin group (U group,28 cases) and control group (group C,28 cases). Results There were no significant differences in liver function and inflammatory factors between the two groups on the 1^st day before the surgry (P〉 0.05). Serum ALT levels of (231±29; 140 ±21; 56 ± 13; 42 ±6) U/L, were lower than group C (267 ± 29 ; 158 ± 23 ; 69 ± 18 ; 53 ±8 ) U/L, all P 〈 0. 05 ; serum AST levels were (175±3; 94±5;47±6; 36±8) U/L, lower than group C (191 ±7; 139±6; 64±5; 46±11) U/L, all P〈0.05; Serum TBIL levels were (30 ±6; 39 ±9; 31 ±9; 21 ±6) μmol/L, lower than group C ( 34 ±6 ; 46 ±7 ; 35 ± 8 ; 26 ± 7 ) μmol/L, all P 〈 0. 05 ; Serum hs-CRP levels were ( 52 ±22 ; 112 ± 23 ; 71 ± 16 ; 42 ± 13 ) mg/L, lower than group C ( 69 ±23 ; 129 ±25 ; 72 ±15 ; 49 ±15 ) mg/L, all P 〈 0. 05 ; serum IL-1β levels were ( 7. 8 ±0. 9 ; 11.1 ±1.5 ; 8. 9 ±1.6 ; 5.6 ±0. 9 ) pg/ml, lower than groupC (9.2±1.3; 13.0±2.1; 11.1 ±1.4; 7.3±0.8) pg/m], all P 〈 0. 05 ; Serum IL-6 levels were (187 ±03; 76±25; 46 ±15; 26 ±8) pg/ml; lower than group C(260 ±6; 92 ±16; 53 ±11; 30 ±8 ) pg/ml, all P 〈 0.05 ; Serum TNF-α levels were ( 17 ±4 ; 12. 0 ±2.4 ; 8. 6 ±2, 4 ; 6.7 ±2. 0) pg/ml, lower than group C ( 25 ±4 ; 18.7 ± 3.3 ; 15. 0 ±3. 1 ; 9. 6 ±1.7 ) pg/ml, all P 〈 0. 05. Conclusion Ulinastatin protects liver function in perioperative patients undergoing precise hepatectomy.
作者 周滨 朱李瑢 常仁安 陈钟 Zhou Bin, Zhu Lirong, Chang Renan, Chen Zhong.(Department of General Surgery, Affiliated Hospital to Nantong University,Nantong 226001, Chin)
出处 《中华普通外科杂志》 CSCD 北大核心 2018年第3期240-243,共4页 Chinese Journal of General Surgery
基金 江苏省临床医学科技专项基金资助项目(BL2014060) 江苏省普通高校研究生科研创新计划基金资助项目(SJZZ16-0251)
关键词 肝细胞 肝切除术 围手术期 Carcinoma, hepatocellular Hepatectomy Perioperative period
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