前列地尔联合高压氧治疗肝硬化合并肝肺综合征的临床研究  

Clinical study of Prostaglandin combined with hyperbaric oxygen therapy in the treatment of patients with hepatopulmonary syndrome

作　　者：李琪毅[1] 姜仕柱[1] 王琴[1] 周颖[2] 

机构地区：[1]三峡大学仁和医院消化内科,湖北宜昌443001 [2]三峡大学仁和医院检验科,湖北宜昌443001

出　　处：《中国现代医学杂志》2014年第35期95-98,共4页China Journal of Modern Medicine

摘　　要：目的探讨前列地尔联合高压氧治疗肝肺综合征对患者血浆ET-1、NO、TNF-α、Pa O2及肝功能的影响。方法选取肝硬化合并肝肺综合征患者60例并随机分为3组:对照组20例,阴性试验组20例,阳性实验组20例。对照组给予常规的护肝及对症支持治疗,阴性试验组在对照组治疗基础上每日加用前列地尔20μg,阳性实验组在阴性实验组的基础上联合高压氧治疗,疗程15 d。检测各组患者血浆ET-1、NO、TNF-α、Pa O2水平及肝功能。结果对照组、阴性试验组及阳性试验组治疗前、后血浆ET-1、NO、TNF-α、Pa O2水平及肝功能差异有显著性(P<0.05);阳性试验组治疗后血浆ET-1、NO、TNF-α水平明显低于阴性实验组和对照组治疗后水平,Pa O2明显高于阴性实验组和对照组治疗后水平(P<0.05)。结论前列地尔联合高压氧治疗可以降低肝硬化合并肝肺综合征患者血浆ET-1、NO、TNF-α水平及升高Pa O2,并改善肝功能,其疗效优于单一应用前列地尔。[Objective ] To observe the influence of Prostaglandin combined with hyperbaric oxygen therapy on plasma tumornecrosis faetor-α（TNF-α）, nitricoxide （NO） and endothelin-1 （ET-1） in patients with hepatopulmonary syndrome （HPS）. [Methods] Sixty patients with hepatopuimonary syndrome were randomly divided into three groups： control group, negative test group and positive control group. Standard medical treatment was arranged to control group; negative test group in additional dosage of Prostaglandin 20 p.g once a day; positive control group in additional the negative test group and hyperbaric oxygen therapy treatment for fifteen. Levels of TNF-α, NO, ET-1, PaO2 and liver function test in every group were measured. [Results] Control group, negative test group and positive control group before and after treatment,the plasma levels of ET-1, TNF-α, PaO2 level and liver function is significant difference （P 〈0.05）; compared to the control group and negative test group, the positive control group of plasma levels of TNF-α, NO, ET-1 significantly decreased, and the level of PaO2 significantly increased after Prostaglandin injection combined with hyperbaric oxygen therapy （P〈0.05）. [Conclusion] Prostaglandin combined with hyperbaric oxygen therapy can reduce the levels of TNF-α, NO and ET-1 in patients with HPS and improve liver function, its curative effect is better than a single application of Prostaglandin.

关 键 词：前列地尔 高压氧 肝肺综合征 肿瘤坏死因子 一氧化氮 内皮素-1 

分 类 号：R575.2[医药卫生—消化系统]