乌司他丁联合异甘草酸镁和还原型谷胱甘肽对肝癌患者肝部分切除术后肝功能的保护效果初步研究  

A preliminary study on the protective effect of combination of ulinastatin with magnesium isoglycyrrhizinate and reduced glutathione on liver functions in patients with primary liver cancer after partial hepatectomy

作　　者：邓清[1] 张铁泉 乐问津 黄强[1] 李宓[1] 鲁号锋 Deng Qin;Zhang Tiequan;Yue Wenjin(Department of Hepatobiliary Surgery, FirstPeople＇s Hospital, Affilated to Yangtze River University, Jingzhou 434000, Hubei Province, Chin)

机构地区：[1]长江大学第一附属医院/第一人民医院肝胆外科,湖北省荆州市434000

出　　处：《实用肝脏病杂志》2018年第3期439-442,共4页Journal of Practical Hepatology

摘　　要：目的探讨乌司他丁联合异甘草酸镁和还原型谷胱甘肽对原发性肝癌(PLC)患者肝部分切除术后肝功能的保护效果。方法 2013年2月~2016年10月收治的78例PLC患者,行开腹或腔镜下肝部分切除术治疗,将术后患者分成两组,给予A组38例患者异甘草酸镁和还原型谷胱甘肽护肝、给予B组40例乌司他丁联合异甘草酸镁和还原型谷胱甘肽护肝治疗。采用ELISA法测定血清肿瘤坏死因子(TNF)-α、白介素(IL)-6和C反应蛋白(CRP)。结果术后7 d和14 d,B组血清谷丙转氨酶(ALT)水平显著低于A组(P<0.05);术后7 d,B组血清CRP、TNF-α和IL-6水平分别为(17.2±2.7)mg/L、(2.7±0.6)pg/ml和(28.4±5.7)pg/ml,均显著低于A组[(19.8±3.2)mg/L、(3.5±0.7)pg/ml和(33.4±6.2)pg/ml,P<0.05],术后14 d,分别为(13.6±3.0)mg/L、(2.0±0.4)pg/ml和(20.5±4.7)pg/ml,也显著低于A组[分别为(16.3±3.5)mg/L、(2.8±0.6)pg/ml和(24.6±4.9)pg/ml,P<0.05];术后,A组与B组隔下积液、胆漏发生和死亡发生率比较,差异无统计学意义(P>0.05),但B组肝衰竭发生率为2.5%,显著低于A组的21.1%(P<0.05)。结论乌司他丁联合异甘草酸镁和还原型谷胱甘肽可加强肝癌患者肝部分切除术后肝功能的保护作用,减轻机体炎症反应。Objective To investigate the protective effect of combination of ulinastatin with magnesiumisoglycyrrhizinate and reduced glutathione on hepatic functions in patients with primary liver cancer after partialhepatectomy. Methods 78 patients with primary liver cancer were included in our hospital between February2013 and October 2016, and they received partial hepatectomy. After operation, the patients were randomly dividedinto groupB, receiving combination of ulinastatin, magnesium isoglycyrrhizinate and reduced glutathione, and groupA, receiving magnesium isoglycyrrhizinate and reduced glutathione. Serum tumor necrosis factor （TNF）-α,interleukin （IL）-6 and C reactive protein （CRP） levels were detected by ELISA. Results There was nosignificant differences between the two groups as respect to the indexes of liver functions and serum inflammatoryfactors before operation （P〉0.05）; serum alanine aminotransferase （ALT） level in group B seven days afteroperation were significantly lower than in groupA （P〈0.05）; at the end of seven days, serum CRP, TNF-α andIL-6 levels in group B were（17.2±2.7）mg/L,（2.7±0.6）pg/ml and（28.4±5.7）pg/ml, much lower than [ （19.8±3.2）mg/L,（3.5±0.7）pg/ml and（33.4±6.2）pg/ml in groupA, P〈0.05], and at the end of 14d, serum CRP, TNF-α and IL-6 levels in group B were（13.6±3.0）mg/L,（2.0±0.4）pg/ml and （20.5±4.7）pg/ml, much lower than[ （16.3±3.5）mg/L,（2.8±0.6）pg/ml and （24.6±4.9） pg/ml in groupA, P〈0.05]; there was no significant differences ofthe incidences of postoperative septal effusion, bile leakage and death between the two groups（P〉0.05）, while theincidence of hepatic failure in group B was significantly lower than that in groupA 2.5% vs. 21.1% P〈0.05 .Conclusion Combination of ulinastatin, magnesiumisoglycyrrhizinate and reduced glutathionecan mightenhance the protective effects on hepatic function inpatients with primary liver cancer after partialhepatectomy.

关 键 词：原发性肝癌 肝部分切除术 乌司他丁 肝功能 

分 类 号：R735.7[医药卫生—肿瘤]