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熊去氧胆酸对不同原因胆汁淤积性肝病患者鼻胆管引流术后胆汁排泌的影响
Effect of ursodeoxycholic acid on bile secretion after endoscopic nasobiliary drainage in patients with cholestatic liver disease of various causes
文章发布日期:2016年02月06日  来源:  作者:李磊,李冰,丁惠国  点击次数:1237次  下载次数:211次

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【摘要】:目的观察熊去氧胆酸(UDCA)对不同原因胆汁淤积性肝病患者胆汁排泌的影响。方法收集2013年7月-2014年5月于首都医科大学附属北京佑安医院接受鼻胆管引流术患者48例,分为UDCA治疗组(36例)和对照组(12例),UDCA治疗组根据病因再分为胆总管结石组(9例)、胆管癌组(7例)、硬化性胆管炎组(7例)、肝移植术后组(13例)。UDCA治疗组患者于术后第2天开始口服UDCA胶囊(250 mg,3次/d),记录术后7 d每日胆汁引流量,于术前1天、术后第7天检测血清TBil、总胆汁酸(TBA)、GGT、ALP水平,比较UDCA对胆汁引流量、TBil、TBA、GGT、ALP的影响。计量资料两组间比较采用t检验,多组间比较采用方差分析;计数资料组间比较采用χ2检验。结果与对照组相比,UDCA治疗组胆汁引流量术后第3、4、5天明显增多,差异均有统计学意义(t值分别为2.461、3.896、2760,P值分别为0.048、0.021、0.034),其中胆总管结石、胆管癌和肝移植术后3组患者胆汁引流量增加较明显,均在术后第4天呈现高峰;与术前1天相比,术后第7天胆总管结石和肝移植术后2组患者TBil、GGT、ALP水平显著降低,差异均有统计学意义(t值分别为3.340、2.503、2.158和2.951、2.805、2.461,P值分别为0.016、0.038、0.045和0014、0.029、0.034)。结论UDCA可增加各种胆汁淤积性肝病的胆汁排泌量,促进肝功能改善。
【Abstract】:ObjectiveTo observe the effect of ursodeoxycholic acid (UDCA) on bile secretion in patients with cholestatic liver disease of various causes. MethodsA total of 48 patients who underwent endoscopic nasobiliary drainage (ENBD) in Beijing You′an Hospital Affiliated to Capital Medical University from July 2013 to May 2014 were enrolled and divided into UDCA treatment group (n=36) and control group (n=12). The patients in the UDCA group were further divided into common bile duct stone group (n=9), cholangiocarcinoma group (n=7), sclerosing cholangitis group (n=7), and post-liver transplantation group (n=13). The patients in the UDCA treatment group received oral UDCA capsules (250 mg, 3 times/day) since the second day after surgery, and the daily volume of bile drainage was recorded for 7 days after surgery. Serum levels of total bilirubin (TBil), total bile acid (TBA), gamma-glutamyl transpeptidase (GGT), and alkaline phosphatase (ALP) were measured on the day before surgery and the 7th day after surgery, and the effects of UDCA on volume of bile drainage, TBil, TBA, GGT, and ALP were compared between groups. The t-test was applied for comparison between groups, comparison of continuous data between these groups was made by analysis of variance; the chi-square test was applied for comparison of categorical data between groups. ResultsCompared with the control group, the UDCA treatment group had a significantly increased volume of bile drainage on the 3rd, 4th, and 5th days after surgery (t=2.461, 3.896, and 2.760; P=0.048, 0.021, and 0.034), and the increase in volume of bile drainage was more significant in the common bile duct stone group, the cholangiocarcinoma group, and the post-liver transplantation group, with peak values appearing on the 4th day after surgery. The patients in the common bile duct stone group and the post-liver transplantation group had significantly lower serum levels of TBil, GGT, and ALP on the 7th day after surgery (t=3.340, 2.503, and 2.158, P=0.016, 0.038, and 0045; t=2.951, 2.805, and 2.461, P=0.014, 0029, and 0.034). ConclusionUDCA can increase bile secretion and improve liver function in patients with cholestatic liver disease of various causes.
【关键字】:肝疾病;胆汁淤积;熊脱氧胆酸;引流术
【Key words】:liver diseases; cholestasis; ursodeoxycholic acid; drainage
【引证本文】:李磊, 李冰, 丁惠国. 熊去氧胆酸对不同原因胆汁淤积性肝病患者鼻胆管引流术后胆汁排泌的影响[J]. 临床肝胆病杂志, 2016, 32(3): 522-525.

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