L-精氨酸对肝硬化腹水的治疗  

Therapeutic efficacy of L - arginine against ascites in patients with liver cirrhosis

作　　者：邵润轩[1] 王江滨[1] 郭佳鹤[1] 周力[2] 

机构地区：[1]吉林大学中日联谊医院消化内科,长春130031 [2]吉林省人民医院,长春130021

出　　处：《临床肝胆病杂志》2002年第2期95-97,共3页Journal of Clinical Hepatology

摘　　要：观察 Ｌ－精氨酸对肝硬化腹水的治疗，选择肝硬化腹水患者 ３０例，健康对照１０例；Ｌ－精氨酸３０ｇ加入无菌注射用水３００ｍｌ中静点，观察用药前后血压、尿量、尿钠排泄、血浆中心房利钠因子（ＡＮＦ）、环磷鸟苷（ｃＧＭＰ），尿中ｃＧＭＰ及一氧化氮（ＮＯｘ）的排泄，观察１９例肝硬化腹水患者长期（２周）静点Ｌ－精氨酸对腹水的疗效。结果表明，Ｌ－精氨酸可使肝硬化腹水患者收缩压、舒张压均降低，尿量、尿钠排泄增加；血浆 ＡＮＦ、ｃＧＭＰ均增加；尿中ｃＧＭＰ及ＮＯｘ的排泄量增加。长期用Ｌ－精氨酸患者尿量明显增加，腹围明显缩小。提示Ｌ－精氨酸对肝硬化腹水有治疗作用，其作用机理可能与其产生一氧化氮增加，从而使肾血管扩张而利尿、利钠有关。To observe the therapeutic efficacy of L - arginine against ascites in patients with liver cirrhosis, 30 patients with liver cirrhosis were enrolled in this study. 10 healthy volunteers served as normal controls. The changes of blood pressure, urine volume, natruresis, the plasma atrial natriuretic factor (ANF) and cyclic guanosine monophosphate (cGMP), Nitric Oxide (NOx) and cGMP in the urine were measured after intravenous L - argnine (30g) and distilled water (300ml). The therapeutic efficacy of 19 patients with liver cirrhosis was observed after intravenous L - arginine for two weeks. The results showed that systolic and diastolic pressure were reduced after intravenous L - arginine. L - argi- nine increased the urine volume, natruresis, cGMP and NOx in the urine. The urine volume was signifcantly increased af- ter intravenous L - arginine and abdominal perimeter can be recovered by Larginine. These suggested L - arginine had therapeutic effect on liver cirrhosis. we suppose that L - arginine will stimulate the release of plasma NO and increase the urine volume and natruresis by the effects of distending kidney vessles.

关 键 词：L-精氨酸 一氧化氮 肝硬化 心房利钠因子 环磷鸟苷 腹水 

分 类 号：R575.2[医药卫生—消化系统] R442.5[医药卫生—内科学]