摘要
目的 :研究肝移植患者术前体内氧自由基的相关指标及与预后的关系。方法 :测定了 18例肝移植患者术前血浆中脂质过氧化物 (LPO)、总抗氧化能力 (TAC)、一氧化氮 (NO)、总胆红素 (T BIL ) ,分析其与预后的关系。结果 :死亡组血浆 L PO(17.13± 4.16)μmol/ L ,明显高于存活组 (7.97± 3 .5 2 )μmol/ L (P<0 .0 5 ) ,存活组血浆 TAC(3 8.0 5± 19.13 ) k U / L ,高于死亡组 (3 2 .5 4± 3 .0 7) k U/ L,但无显著性差异 (P>0 .0 5 ) ;存活组血浆NO (5 0 .46± 19.5 4)μmol/ L,死亡组 (5 0 .80± 14 .80 )μmol/ L ,无显著性差异 (P>0 .0 5 ) ;死亡组血 T BIL(4 2 5 .98± 2 14 .18) μmol/ L,明显高于存活组 (172 .10± 14 4.3 2 ) μmol/ L(P<0 .0 5 )。从结果筛选出对判断预后有意义的指标为血浆 LPO和血浆 TAC,建立根据术前检验指标预测术后死亡与存活的判别函数式分别为 :Y1 =0 .3 2 90 X1 + 0 .0 998X2 ,3 .90 40 ,Y2 =1.3 5 2 0 X2 -0 .0 5 0 0 X2 -11.464 0 (其中 X1 为血浆 LPO,X2 为血浆 TAC) ;判别方程对存活组判别正确率为 10 0 .0 % ,对死亡组判别正确率为 83 .3 % ,总的判别正确率为94.4%。结论 :术前检测血浆 LPO和 TAC能较正确判断患者的死亡危险程度 ,可作为术前常规检查。判别方程判别?
Objective: To research the relationship of oxygen free radicals related i ndex before liver transplantation with prognosis. Methods: Lipid pero xide(LPO), total antioxidant capacity(TAC), nitric oxide(NO) and total bilirubin (TBIL) in blood from 18 patients were measured before liver transpla ntation, and the relationship with prognosis was analyzed. Results: The blood LPO of death group was (17 13± 4 16)μmol/L, it was obvi ou sly higher than that of survival group (7 97±3 52) μmol/L (P<0 05). The blood TAC of survival group was (38 05±19 13)kU/L, it was higher than that of death group (32 54± 3 07)kU/L, but th ere wa s no obvious difference(P>0 05). There was no obvious differ ence between the blood NO of death group was (50 80±14 80)μmol/ L, and survive group was (150 46±19 54)μmol/L (P>0 05). The blood TBIL of death group was (425 98±214 18) μmol/L, it was obviously higher than that of survival group(172 10±1 44 32)μmol/L (P<0 05). So the blood LPO and TAC were choosen as the index to forejudge prognosis, and an equation was estab lished to forecast if the patient would be death or survive: Y 1=0 32 9 0 X 1+0 099 8 X 2-3 904 0, Y 2=1 352 0 X 1-0 0 50 0 X 2-11 464 0, X 1 represented serum LPO, X 2 represented serum TAC. 100 0 percent accuracy was forecasted in the survival group by the equation, 83 3 percent accuracy was in the death group. The overall patients were forejudged 94 4 percent accurat ely. Conclusion: Measuring LPO and TAC in blood maybe forejudging prognosis properly and can be u se d as routine examination before liver transplantation. The equation is preferabl e to forejudging prognosis, it can be used to choose from high risk patients to improve survival rate of the patients after operation. Therefore, it is val uable in clinical practise.
出处
《中国危重病急救医学》
CAS
CSCD
2003年第9期560-562,共3页
Chinese Critical Care Medicine
