牛磺熊去氧胆酸与熊去氧胆酸对肝移植术后肝功能恢复的疗效比较

发布时间：2018-05-01 20:43

本文选题：肝移植 + 胆汁淤积　；参考：《器官移植》2016年03期

【摘要】：目的比较牛磺熊去氧胆酸与熊去氧胆酸用于改善肝移植术后肝功能的临床效果。方法选择2006年至2012年在首都医科大学附属北京友谊医院接受原位肝移植手术的受者28例,术后即开始口服熊去氧胆酸,治疗3个月转换为口服牛磺熊去氧胆酸6个月。比较入组前,入组后1、2、3、4、5、6、9个月的总胆汁酸(TBA)、总胆红素(TB)、直接胆红素(DB)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)的变化情况。其中5例分别于入组3个月和9个月行胆汁酸成分测定,比较疏水性胆汁酸与亲水性胆汁酸的变化情况。结果应用熊去氧胆酸后,肝功能各项指标在入组3个月内均有所上升。应用牛磺熊去氧胆酸后,与入组3个月比较,TBA在入组5、9个月明显降低;ALT在入组5、6个月时下降;AST在入组4、5个月下降;ALP在入组9个月明显下降;GGT在入组6、9个月下降(均为P0.05)。应用牛磺熊去氧胆酸后,患者胆汁酸中亲水性胆汁酸富集,以牛磺熊去氧胆酸为主。结论肝移植术后应用牛磺熊去氧胆酸的利胆及保护肝功能作用比熊去氧胆酸更强。
[Abstract]:Objective to compare the clinical effects of ursodeoxycholic acid and ursodeoxycholic acid for improving liver function after liver transplantation. Methods 28 patients receiving orthotopic liver transplantation in Beijing Friendship Hospital of Capital Medical University from 2006 to 2012 were selected. After operation, orally ursodeoxycholic acid began to take place, and the treatment for 3 months to oral oxo ursodeoxycholic acid was used. Cholic acid for 6 months. The changes in total bile acid (TBA), total bilirubin (TB), direct bilirubin (DB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and gamma glutamyl transaminopeptidase (GGT) were compared in 1,2,3,4,5,6,9 months before the group. Among them, bile acids were measured in 5 cases, respectively, in 3 and 9 months, respectively. The changes of hydrophobic bile acids and hydrophilic bile acids were compared. Results after the application of ursodeoxycholic acid, all indexes of liver function increased in 3 months. After the use of tauroxiong deoxycholic acid, compared with the 3 months in the group, TBA decreased significantly in the group of 5,9 months, and ALT decreased in the group 5,6 months; AST decreased in the group of 4,5 months; ALP After 9 months of entry, GGT decreased in the group of 6,9 months (all P0.05). After the use of tauroxiong deoxycholic acid, the hydrophilic bile acid in the bile acid was enriched and the tauroxiursodeoxycholic acid was the dominant factor. Conclusion the cholic acid and the protective liver function of the tauroxiursodeoxycholic acid after liver transplantation were stronger than ursodeoxycholic acid.

【作者单位】：天津医科大学;首都医科大学附属北京友谊医院国家消化系统疾病临床医学研究中心
【基金】：北京市卫生系统高层次卫生技术人才项目(2014-2-002)
【分类号】：R657.3

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