S-腺苷-L-蛋氨酸治疗全肠外营养导致的胆汁淤积  

Clinical use of S-adenosyl-L-methionine for the treatment of total parenteral nutrition-induced cholestasis

作　　者：王少华[1] 李宁[1] 任建安[1] 朱维铭[1] 刘放南[1] 黎介寿[1] 

机构地区：[1]南京军区南京总医院全军普通外科研究所,210002

出　　处：《中华普通外科杂志》2000年第12期746-747,共2页Chinese Journal of General Surgery

摘　　要：目的　观察S 腺苷 L 蛋氨酸 (SAMe)治疗不中断TPN(全肠外营养 )导致胆汁淤积的疗效。方法　对 8例应用TPN大于 4周、发生胆汁淤积的患者 ,给予TPN支持同时应用SAMe(思美泰 )5 0 0mg每日 2次 ,静脉点滴注射 ,连续应用 4周。结果　治疗后血浆总胆红素、r 转肽酶、碱性磷酸酶、丙氨酸转氨酶、天冬氨酸转氨酶明显降低 (P <0 0 5 ) ,半胱氨酸、牛磺酸、谷胱甘肽含量明显增高(P <0 0 5 ) ,肝脏穿刺活体组织检查示肝细胞内胆汁淤积及汇管区炎症减轻 ,胆小管内胆栓溶解。结论　静脉给予S 腺苷 L 蛋氨酸具有明显的治疗TPN所致胆汁淤积的作用。Objective[WT5”BZ] To evaluate the effectiveness of S adenosyl L methionine (SAMe) in the management of total parenteral nutrition (TPN) induced cholestasis without discontinuing TPN.[WT5”HZ]Methods [WT5”BZ]Eight patients developed cholestasis after parenteral nutrition for more than 4 weeks. SAMe 500 mg, given twice daily, were infused together with TPN continuously for a period of 4 weeks.[WT5”HZ]Results [WT5”BZ]Marked decrease ( P <0 05) of serum bilirubin, γ glutamyl transpeptidase, alkaline phosphatase, glutamic pyruvic transaminase and glutamic oxalacetic transaminase was detected after SAMe treatment, while the concentration of cysteine and taurine increased significantly ( P <0 05).Liver biopsy revealed alleviation of cholestasis within hepatopcytes as well as decreased inflammatory changes in portal tracts, along with thrombi dissolution in bile ductules.[WT5”HZ]Conclusion [WT5”BZ]SAMe given intravenously was significantly effective against TPN induced cholestasis. [WT5”HZ]

关 键 词：全胃肠外营养 氨基酸类 胆汁郁积 治疗 

分 类 号：R459.3[医药卫生—治疗学]