摘要
目的探讨还原型谷胱甘肽对肝硬化上消化道大出血患者预后的影响。方法42例患者给予还原型谷胱甘肽静滴(1.2g/d),疗程4周,并以常规治疗45例作对照。分别测定患者血中谷胱甘肽(GSH)水平、谷胱甘肽过氧化物酶(GSH-Px)活性和过氧化脂质(MDA)含量。以患者出血后发生腹水或腹水增多、黄疸或黄疸加深、肝性脑病和病死4个指标的累计频次数反映病情恶化。结果患者血中GSH水平、GSH-Px/MDA比值出血后均明显下降,72h达最低点,2周后开始回升。经还原型谷胱甘肽治疗的患者,上述指标2周后即显著恢复,4周后可达到出血前水平。其4个病情恶化指标的累计频次数也明显降低(24/42;41/45,P<0.01),且与Child-Pugh分级有关。结论肝硬化患者上消化道大出血后病情恶化可能与其抗氧化能力降低有关,抗氧化治疗有积极意义。
[Objective] To study the effects of glutathione on the prognosis of liver cirrhosis patients with massive upper gastrointestinal hemorrhage. [Methods] After the patients were treated with glutathione （1.2-1.6 g/d, iv.） for 4 weeks, the glutathione （GSH） level in blood, the glutathione peroxidase （GSH-Px） hctivity and the lipid peroxide （MDA） level in plasma were determined. Meanwhile, the clinical significance of glutathione therapy on the patients was observed. [Results] The GSH level and GSH-Px/MDA ratio in all patients were decreased significantly after bleeding. The lowest point of the GSH level and GSH-Px/MDA ratio were observed at 72 h after bleeding, while the GSH level and GSH-Px/MDA ratio in patients treated with glutathione were higher than those in controls （GSH, （1.75±0.25） vs （1.15±0.20）, P 〈0.01; GSH-Px/MDA, （0.11±0.03） vs （0.07±0.02）, P 〈0.01）. The recovery changes were observed at 2 w after bleeding. A better prognosis correlating with Child-Pugh degree was noticed in patients treated with glutathione, too. [Conclusion] The antioxidative capability of patients with liver cirrhosis is decreased after massive upper gastrointestinal hemorrhage, and glutathione therapy could increase the patients GSH-Px/MDA ratio and improve their prognosis.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2005年第16期2401-2404,共4页
China Journal of Modern Medicine
关键词
谷胱甘肽
肝硬化
缺血再灌注
脂质过氧化
glutathione
liver cirrhosis
isehemia-reperfusion
lipid peroxidation
