N-乙酰半胱氨酸对梗阻性黄疸患者PTCD术后肝肾功能的影响

摘要/Abstract

摘要： 目的探究N-乙酰半胱氨酸对梗阻性黄疸患者经皮肝穿刺胆道引流(PTCD)术后肝肾功能的影响。方法选择2018年5月至2019年3月西京医院收治的110例梗阻性黄疸患者作为研究对象, 所有患者均行PTCD术以解除胆道梗阻, 根据术后接受的治疗不同随机分为观察组和对照组, 每组分别为55例。对照组术后给予常规治疗, 观察组在对照组基础上同时给予静脉注滴N-乙酰半胱氨酸治疗。观察两组患者术前1 d和术后7 d肝功能指标、胆道梗阻指标及肾功能指标的改变情况。结果术前1 d, 两组患者肝功能指标血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(γ-GT)、碱性磷酸酶(ALP)和胆道梗阻指标血清总胆红素(TBil)、直接胆红素(DBil)、胆汁酸(TBA)水平以及肾功能指标尿白蛋白(Alb)、尿视黄醇结合蛋白(RBP)及尿转铁蛋白(TRF)水平比较差异均无统计学意义(P>0.05);与术前1 d相比, 术后7 d两组患者血清ALT、AST、γ-GT、ALP、TBil、DBil、TBA水平以及尿Alb、RBP、TRF水平均降低(P<0.05);且术后7 d观察组血清ALT、AST、γ-GT、ALP、TBil、DBil、TBA水平以及尿Alb、RBP、TRF水平均显著低于对照组(P<0.05)。结论 N-乙酰半胱氨酸对梗阻性黄疸PTCD术后患者的肝肾功能具有良好的保护作用, 临床价值较高。

关键词: N-乙酰半胱氨酸, 梗阻性黄疸, 经皮肝穿刺胆道引流, 肝功能, 肾功能

Abstract: Objective To investigate the effect of N-acetylcysteine on liver and kidney function in patients with obstructive jaundice after percutaneous transhepatic cholangial drainage (PTCD).Methods A total of 110 patients with obstructive jaundice admitted to our hospital from May 2018 to March 2019 were selected as study objects. All patients were treated with PTCD to relieve biliary obstruction. According to the different treatment, they were randomly divided into the observation group and the control group, with 55 cases in each group. The control group was given conventional therapy after operation, and the observation group was given intravenous N-acetylcysteine treatment supplemented to conventional therapy. The indexes of liver function, biliary obstruction and kidney function were recorded in 2 groups 1 day before and 7 days after operation. Results There was no significant difference in the indexes of liver function (alanine aminotransferase, aspartate aminotransferase, γ-glutamine transpeptidase and alkaline phosphatase), biliary obstruction (total bilirubin, direct bilirubin and bile acid), and kidney function (urinary albumin, urinary retinol binding protein and urinary transferrin) between 2 groups 1 day before operation (P>0.05). Liver function, biliary obstruction and kidney function improved 7 days after PTCD in 2 groups (P<0.05). And all these indexes improved more in observation group than control group (P<0.05).Conclusion N-acetylcysteine can protect liver and kidney function of patients with obstructive jaundice after PTCD, with high clinical value.

Key words: N-acetylcysteine, Obstructive jaundice, Percutaneous transhepatic cholangial drainage, Liver function, Kidney function

罗婷, 张粉, 白燕, 张林颖. N-乙酰半胱氨酸对梗阻性黄疸患者PTCD术后肝肾功能的影响[J]. 肝脏, 2021, 26(4): 417-420.

LUO Ting, ZHANG Fen, BAI Yan, ZHANG Lin-ying. Effect of N-acetylcysteine on liver and kidney function in patients with obstructive jaundice after PTCD[J]. Chinese Hepatolgy, 2021, 26(4): 417-420.

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