Analysis of serum bile acid changes in patient of oral administration of UDCA after hepatocellular carcinoma resection
-
摘要: 目的 对原发性肝癌手术切除患者服用熊去氧胆酸(ursodeoxycholic acid,UDCA)后血清胆汁酸浓度变化进行分析,为临床治疗提供合理建议。 方法 抽取2009年1月~2010年1月服用过熊去氧胆酸的原发性肝癌手术患者病历89份进行分析。 结果 ①用药前血清胆汁酸浓度变化值最大值为131.10 μmol/L,最小值为-69.00 μmol/L,四分位数间距为15.30 μmol/L;用药后血清胆汁酸变化值最大为275.20 μmol/L,最小值为-49.00 μmol/L,四分位数间距为30.50 μmol/L。②与用药前血清胆汁酸浓度变化相比,用药后血清胆汁酸浓度明显升高,P<0.01。③这种升高与用药前的Child-Pugh评分显著相关,P<0.01,与熊去氧胆酸用药剂量、术中出血量、肝门阻断时间、手术者、肝硬化程度等因素不相关。 结论 原发性肝癌手术患者服用熊去氧胆酸应考虑的首要因素是用药前的Child-Pugh评分。Abstract: Objective To analyze the serum bile acid changes in patient of oral administration of UDCA after hepatocellular carcinoma resection and provide reasonable recommendations for clinical staffs. Methods 89 cases with hepatocellular carcinoma after taking UDCA had been analyzed during 2009.01 to 2010.01. Results Serum bile acid concentration changes before medication of UDCA had been showed that the maximum value was 131.10 μmol/L, the minimum value was -69.00 μmol/L, quartile spacing was 15.30 μmol/L,and after medication, the maximum value was 275.20 μmol/L, the minimum value was -49.00 μmol/L, quartile spacing 30.50 μmol/L. The serum bile acid concentrations after medication of UDCA had increased significantly compared with the status before medication, P<0.01. The Child-Pugh scores before the medication of UDCA was correlated to the changes of serum bile acid after the medication of UDCA,P<0.01.The other variables, UDCA dosage, the amount of bleeding during operation, blocking time of portal vein, the different surgeon, cirrhosis were not correlated to the changes of serum bile acid after the medication of UDCA. Conclusion The Child-Pugh scores before the medication of UDCA should be the prime considerable factor as concerned.
-
Key words:
- ursodeoxycholic acid (UDCA) /
- liver function /
- serum bile acid
-
[1] 唐海鸿,陈英杰,童光东,等.熊去氧胆酸联合通胆汤对原发性胆汁性肝硬化的治疗作用[J].世界华人消化杂志,2008,16(13):1417. [2] 陈文斌,潘祥林,康熙雄,等.诊断学[M].第6版.北京:人民卫生出版社,2004:401. [3] Tomomichi I,Kaoru I,Shuji K,et al.Protective effects of ursodeoxycholic acid on chenodeoxycholic acid-induced liver injury in hamsters[J]. World J Gastroenterol, 2007,13(37):5003. [4] 刘丽萍,贺承山.熊去氧胆酸治疗肝脏疾病的作用机制和临床应用进展[J].解放军药学学报,2004,20(4):283. [5] 李筱琳,王学强,葛秀林.熊去氧胆酸治疗淤胆型肝炎128例[J].实用医药杂志,2009,26(9):26. [6] 乔显微,董伟力,赵延玲.熊去氧胆酸胶囊治疗淤胆型肝炎64例临床疗效观察[J].实用医院临床杂志,2008,5(6):111. [7] La A,Ja C,Sa H.Effect of oral ursodeoxycholic acid on bile acids tolerance tests in healthy dogs[J]. Australian Veterinary J,2004,82(3):157. [8] 王 蓓,孙百军,李东华,等.中药利胆灵对胆色素结石患者引流胆汁中胆汁酸的影响[J].天津中医药,2007,24(2):110. [9] 代春江.熊去氧胆酸胶囊溶出度测定方法研究[J].中国药业,2008,17(7):19. [10] 罗生强,刘 钎,吉英杰,等.37例原发性胆汁性肝硬化的临床分析[J].药品评价,2007,4(5):352. [11] 陈建清,胡良凯,张建民.熊去氧胆酸在胆汁淤积性肝病中的应用[J].国际消化病杂志,2008,28(6):474. [12] 张学风,郭 辉.熊去氧胆酸胶囊治疗老年戊型淤胆型肝炎的临床观察[J].中国老年保健医学,2008,6(1):62. [13] Konno T,Tada K,Akamatsu K. Effect of dobutamine on serum bile acid levels in patients with cirrhosis[J].Current Therapeutic Research,1997,58(8):515. [14] 邵红征,李祥金.肝硬化患者血清总胆汁酸测定的临床意义[J].现代消化及介入诊疗,2009,14(3):193. [15] 石 旺,芦 琴.原发性肝癌病人血清总胆汁酸和转铁蛋白水平与Child分级的关系[J].中国基层医药,2004,11(5):600. -
点击查看大图
计量
- 文章访问数: 2761
- HTML全文浏览量: 235
- PDF下载量: 109
- 被引次数: 0
下载:
