普萘洛尔降门脉压对肝硬化失代偿期患者肠道屏障功能的影响  

Effect of reducing portal pressure on intestinal barrier function in patients with decompensated cirrhosis

作　　者：姜齐宏[1] 陈艳[1] 王爱祥[1] 骆中华[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院消化内科,湖北省武汉市430034

出　　处：《世界华人消化杂志》2014年第24期3665-3669,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨普萘洛尔降门脉压对肝硬化失代偿期患者肠道屏障功能的影响.方法:按照随机数字表法将华中科技大学同济医学院附属普爱医院收治的86例病毒性和酒精性肝硬化失代偿期(门静脉高压)患者均分为实验组和对照组,对照组患者给予常规护肝和对症支持治疗,实验组患者在此基础上加用盐酸普萘洛尔片治疗,比较两组患者治疗前后门静脉宽度、丙氨酸氨基转移酶(alanineaminotransferase,ALT)、天冬氨酸氨基转移酶(aspartic transaminase,AST)、总胆红素(totalbilirubin,TBIL)、血清白蛋白(serum albumin,ALB)水平、血浆内毒素水平、D-乳酸含量及血浆二胺氧化酶(plasma diamine oxidase,DAO)活性变化情况.结果:实验组患者治疗后门静脉宽度显著下降,与治疗前比较(1.37 cm±0.09 cm vs 1.41cm±0.11 cm),差异具有统计学意义(P<0.05);实验组患者治疗后门静脉宽度显著低于对照组(1.37 cm±0.09 cm vs 1.39 cm±0.10 cm),差异具有统计学意义(P<0.05);两组患者治疗后ALT、AST和TBIL水平均显著下降,ALB水平均显著升高,与治疗前比较(35.15 U/L±11.92 U/L vs 42.76 U/L±18.06 U/L,29.03 U/L±13.88 U/L vs 35.04 U/L±19.84 U/L,19.57μmol/L±10.59μmol/L vs 25.65μmol/L±15.09μmol/L,32.69 g/L±3.96 g/L vs 30.16 g/L±5.63 g/L,34.03 U/L±11.46 U/L vs 42.91 U/L±17.67 U/L,28.36 U/L±14.37 U/L vs 36.62 U/L±20.54 U/L,18.94μmol/L±9.56μmol/L vs24.92μmol/L±16.60μmol/L,32.28 g/L±6.13 g/L vs 29.94 g/L±5.06 g/L),差异具有统计学意义(P<0.05);两组患者治疗后ALT、AST、TBIL和ALB水平比较(35.15 U/L±11.92 U/L vs 34.03 U/L±11.46 U/L,29.03 U/L±13.88 U/L vs 28.36±14.37 U/L,19.57μmol/L±10.59μmol/L vs 18.94μmol/L±9.56μmol/L,32.69g/L±3.96 g/L vs 32.28 g/L±6.13 g/L),差异无统计学意义(P>0.05);两组患者治疗后血浆内毒素水平、DAO活性、D-乳酸水平均显著下降,与治疗前比较(0.53 EU/mL±0.12 EU/mL vs 0.72 EU/mL±0.11 EU/mL,2.71 Ku/L±0.84 Ku/L vs 5.19 Ku/L±2.12 Ku/L,7.85 mg/L±0AIM： To explore the effect of reducing portalpressure on intestinal barrier function in patientswith decompensated cirrhosis.METHODS： Eighty-six patients with decom-pensated viral liver cirrhosis or alcoholic cir-rhosis were randomly divided into either an ex-periment group or a control group. The controlgroup received conventional symptomatic andsupportive treatment, and the experiment groupwas additionally given propranolol hydrochlo-ride tablets. The width of the portal vein, alanineaminotransferase（ALT）, aspartic transaminase（AST）, total bilirubin（TBIL）, serum albumin（ALB）, plasma endotoxin level, D-lactic acid con-tent and plasma diamine oxidase（DAO） were compared between the two groups.RESULTS： The width of the portal vein in the experiment group posttreatment was signifi-cantly lower than that before treatment（1.37 cm ± 0.09 cm vs 1.41 cm ± 0.11 cm, P〈0.05） and that in the control group（1.37 cm ± 0.09 cm vs 1.39 cm ± 0.10 cm, P〈0.05）. The levels of ALT, AST and TBIL in both groups posttreatment were significantly lower and the levels of ALB were significantly higher than those before treatment（35.15 U/L ± 11.92 U/L vs 42.76 U/L ± 18.06 U/L, 29.03 U/L ± 13.88 U/L vs 35.04 U/L ± 19.84 U/L, 19.57 μmol/L ± 10.59 μmol/L vs 25.65 μmol/L ± 15.09 μmol/L, 32.69 g/L ± 3.96 g/L vs 30.16 g/L ± 5.63 g/L, 34.03 U/L ± 11.46 U/L vs 42.91 U/L ± 17.67 U/L, 28.36 U/L ± 14.37 U/L vs 36.62 U/L ± 20.54 U/L, 18.94 μmol/L ± 9.56 μmol/L vs 24.92 μmol/L ± 16.60 μmol/L, 32.28 g/L ± 6.13 g/L vs 29.94 g/L ± 5.06 g/L, P〈0.05）, although there were no significant differences in the levels of ALT, AST, TBIL and ALB between the two groups posttreatment（35.15 U/L ± 11.92 U/L vs 34.03 U/L ± 11.46 U/L, 29.03 U/L ± 13.88 U/L vs 28.36 ± 14.37 U/L, 19.57 μmol/L ± 10.59 μmol/L vs 18.94 μmol/L ± 9.56 μmol/L, 32.69 g/L ± 3.96 g/L vs 32.28 g/L ± 6.13 g/L, P〈0.05）. Plasma endotoxin level, D-lactic acid content and DAO in the two groups posttreatment were signifi

关 键 词：普萘洛尔 门静脉高压 肝硬化 肠道屏障 

分 类 号：R575.2[医药卫生—消化系统]