肝素改善慢性乙型肝炎患者肝脏微循环的临床研究  

Clinical Studies on Imoprovement of Hepatic Microcirculation in Patients with Chronic Hepatitis B

作　　者：郝菁华[1] 石军[1] 任万华[1] 韩国庆[1] 王万忠[1] 朱菊人[1] 王书运[1] 谢英渤[1] 

机构地区：[1]山东省立医院肝病中心,济南250021

出　　处：《微循环学杂志》2001年第4期9-11,共3页Chinese Journal of Microcirculation

摘　　要：目的 :观察肝素 /低分子量肝素改善慢性乙型肝炎患者肝脏微循环的疗效 ,探讨其作用机制、剂量、疗程及不良反应。方法 :36例慢性乙型肝炎患者随机分为A、B二组。A组 14例 ,给予常规治疗 ;B组 2 2例 ,在常规治疗的基础上加用肝素 /低分子量肝素 ,其中 12例应用肝素 ,10例应用低分子量肝素。每位患者用药至少二周。治疗前后分别检测肝功能、血清透明质酸 (HA)水平、vW因子 (vWF)含量、AT Ⅲ活性。B组中有 5例患者在治疗前后分别行肝活组织检查。结果 :治疗半月前后 ,A、B二组ALT、PT水平下降 ,但无统计学意义。B组HA、vWF水平显著下降。肝素组与低分子量肝素组相比 ,AT Ⅲ活性显著下降。与治疗前相比 ,治疗后肝细胞肿胀减轻 ,肝窦腔通畅 ,毛细胆管淤胆减轻。结论 :肝素 /低分子量肝素可以改善肝脏微循环 ,短期应用无明显不良反应。低分子量肝素应用更安全 ,值得推广。Objective: In order to observe the effect of heparin/low molecule weight heparin(LMWH) on hepatic microcirculation,heparin/LMWH were used in patients with chronic hepatitis B.Method: 36 cases were divided into two groups.Group A,including 14 cases,was taken regular regimen.While group B,including 22 cases,was given heparin/LMWH,in addition to regular regimen.Hepatic functions,serum hyaluronate(HA) levels,vWF concentrations,and AT-Ⅲ activities were measured before and after treatment,respectively.5 cases in group B were taken liver biopsy twice.Results: Compared with group A,HA,vWF,D-Dimer,HCT levels in group B were decreased significantly.In addition,AT-Ⅲ activities were decreased much more in patients taking heparin than those taking LMWH.After using heparin/LMWH for two weeks,liver cells were less swollen,the sinusoids being clear,and cholestasis lessened.Conclusion: Heparin/LMWH can improve the hepatic microcirculation without marked side effects.Compared with heparin,LMWH was more safe and convenient.

关 键 词：肝素 慢性乙型肝炎 肝脏微循环 肝脏活组织检查 

分 类 号：R512.62[医药卫生—内科学]