水飞蓟宾胶囊对行肝切除术后患者肝脏保护作用的临床评价  

Proctive effects of silybin capsules on liver in patients after hepatectomy

作　　者：李巍[1] 董晓彤[2] 傅华[1] 于爱军[1] 刘金龙[1] 李剑[1] 

机构地区：[1]承德医学院附属医院肝胆外科,河北承德067000 [2]承德医学院护理学院,河北承德067000

出　　处：《中国医院药学杂志》2017年第10期980-983,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:研究水飞蓟宾对行肝切除术后患者的肝脏临床保护作用。方法:对某院行肝切除术的患者随机分为观察组和对照组,其中观察组患者于实验前一个星期给予水飞蓟宾胶囊,术后静脉滴注还原型谷胱甘肽和异甘草酸镁注射液治疗,对照组患者仅于术后静脉滴注还原型谷胱甘肽和异甘草酸镁注射液治疗,术后7 d内观察记录患者的肝衰竭和肝功能不足发生情况,于术前及术后1,3,5 d和7 d,测定患者血清中总胆红素(TBIL)、直接胆红素(DBIL)、谷丙转氨酶(ALT)和谷草转氨酶(AST)水平,评估水飞蓟宾胶囊对术后患者肝脏保护作用。结果:观察组肝衰竭和肝功能不足发生率显著低于对照组(χ~2=6.202,P=0.013<0.05;χ~2=4.579,P=0.032<0.05);术后1 d,观察组的ALT水平为(287.5±115.8)U·L^(-1),AST水平为(215.7±121.4)U·L^(-1),TBIL水平为(23.3±9.7)μmol·L^(-1),DBIL水平为(8.6±5.1)μmol·L^(-1),对照组的ALT(387.5±156.9)U·L^(-1),AST水平为(316.8±176.4)U·L^(-1),TBIL水平为(27.4±10.3)μmol·L^(-1),DBIL水平为(13.2±5.3)μmol·L^(-1),2组相比,差异有统计学意义(P<0.05)。术后7 d,观察组患者的ALT水平为(41.4±11.5)U·L^(-1),AST水平为(31.9±6.3)U·L^(-1),TBIL水平为(5.5±5.4)μmol·L^(-1),DBIL水平为(4.2±3.4)μmol·L^(-1),对照组患者的ALT水平为(114.7±35.2)U·L^(-1),AST水平为(98.5±13.7)U·L^(-1),TBIL水平为(14.3±5.8)μmol·L^(-1),DBIL水平为(7.2±3.5)μmol·L^(-1),2组相比,差异有统计学意义(P<0.05)。结论:术前应用水飞蓟宾胶囊,可有效减轻手术对肝功能的影响;术后应用水飞蓟宾胶囊治疗,可以显著恢复患者肝功能。OBJECtIVE To evaluate the protective effects of silybin capsules on liver in patients after hepatectomy. METH- ODS Patients after hepatectomy were randomly divided into the observation group and control group. Patients in observation group received silybin capsules one week before operation, reduced glutathione and magnesium isoglycyrrhizinate after opera- tion. Patients in control group received reduced glutathione and magnesium isoglycyrrhizinate after operation. Hepatic failure and insufficiency were observed and recorded within 7 days after operatiorL The levels of TBIL, DBIL, ALT and AST were de- tected 1, 3, 5 and 7 days after operation to evaluated liver protecting effects of silybin capsules. RESULTS The incidences of liver failure and liver insufficiency were significantly higher in the observation group than those in the control group （Z2 = 6. 202, P = 0. 013〈0. 05;Z2 = 4. 579, P= 0. 032〈20. 05）. One day after the surgery, the levels of ALT, AST, TBIL and DBIL were （287.5±115.8） U-L I （215.7±121.4） U＇L 1, （23.3±-9.7） ~mol-L-1 and （8.6±5. l） ~mol.L 1 in the observation group, and （387.5＋156.9）U. L-1, （316.8±176.4）U.L 1, （27.4＋10.3） ptmol.L i and （13.2±5.3） μmol-L / inthe control group, respectively. The difference between the two groups was significantly different （P^0. 05）. Seven days after the surgery, the levels of ALT, AST, TB1L and DBIL were （41.4 ± 11.5） U·L^-1 , （31.9 ＋ 6. 3）U·L^-1, （5.5 ± 5.4） μmol·L^-1 and （4. 2 ± 3.4） μmol.L^-1 in the observation group, and （114. 7 ± 35.2）U·L^-1, （98. 5 ± 13.7） U·L^-1 , （14. 3 ± 5.8） μmol^-1. and （7. 2 ± 3.5） μmol. L-1 in the eontorl group, respectively. The difference between the two groups was significantly different （P%0. 05）. CONCLUSION Silybin capsules can effectively reduce the impact of surgery on liver functions if administered before operation, and significantly restore the liver functions if administered after operation.

关 键 词：水飞蓟宾胶囊 肝切除术 肝脏保护 

分 类 号：R969[医药卫生—药理学]