乌司他丁在体外膜肺氧合中的肝保护作用.PDFVIP

2012;32(10) 南方医科大学学报（J South Med Univ ） ·1511 · 临床研究 乌司他丁在体外膜肺氧合中的肝保护作用 李斌飞，廖小卒，程 周，张志刚 广东中山市人民医院麻醉科，广东 中山 528403 摘要：目的探讨乌司他丁在体外膜肺氧合(ECMO)中对肝脏的保护作用。方法 40 例行ECMO 治疗的患者按入院号随机分为 A ，B 两组，其中A 组为乌司他丁组，B 组为对照组。采集患者ECMO 治疗后12、24、48 h 的静脉血对肝功能指标ALT ，AST 进行 检测。结果A ，B 两组患者行ECMO 前的肝功能差异没有统计学意义，A ，B 患者在ECMO 治疗后的12 h 后的肝功能最差，24 h 后逐渐改善，但乌司他丁组的肝功能受损明显程度明显小于对照组（P0.05），ECMO 能显著改善肝功能。结论 ECMO 能显著 改善肝功能，体外膜肺氧合中患者的肝功能在第12小时受损到达高峰。乌司他丁对体外膜肺氧合中的肝具有保护作用。 关键词：体外膜肺氧合；肝保护；乌司他丁 中图分类号：R575.1; R975 文献标志码：A 文章编号：1673-4254（2012）10-1511-03 doi: 10.3969/j.issn. 1673-4254.2012.10.029 /kcms/detail/44.1627.R2031.010.html Effect of ulinastatin for hepatoprotection following extracorporeal membrane oxygenation LI Binfei, LIAO Xiaozu, CHENG Zhou, ZHANG Zhigang Departments of Anesthesiology, Zhongshan Peoples Hospital, Zhongshan 528403, China Abstract: Objective To explore the effect of ulinastatin in hepatoprotection following extracorporeal membrane oxygenation (ECMO). Methods Forty patients with ECMO were randomized into two groups to receive ulinastatin treatment or not. Venous blood samples were collected to test ALT and AST levels following ECMO treatment for 12, 24 and 48 h. Results The two groups showed no significant difference in liver function indices before ECMO treatment. In both groups, the liver function worsened significantly after a 12-h ECMO treatment, but improved gradually after 24 h. The liver function damages were obviously lessened in ulinastatin group compared to those in patients without ulinastatin treatment (P0.05). ECMO treatment significantly improved the liver function of the patients. Conclusion ECMO can significantly improve the liver function. The liver function damage reaches the peak level after a 12-h ECMO treatment, and ulin