摘要
目的 探讨乳果糖对急性胆道梗阻患者肾功能的保护作用及其机制。方法 5 5例急性胆道结石梗阻患者随机分为乳果糖组 (L组 ,n =2 8)和对照组 (C组 ,n =2 7) ,分别于术前 3d连续口服 5 0 %乳果糖 (L组 )或 10 %葡萄糖 (C组 ) ,定期测定外周静脉血及术中门静脉血内毒素 (ET )浓度 ,血尿素氮 (BUN )及内生肌酐清除率 (Ccr)。结果 (1)L组在第 4天 (手术当天 ) ,第 9天 (手术后第 5天 )时外周血ET水平及BUN浓度均显著低于C组 (P <0 .0 1,P <0 .0 5 ) ;Ccr显著高于C组(P <0 .0 1)。与第 1天 (服药前 )相比 ,外周血ET水平在第 4天 ,第 9天均显著降低 (P <0 .0 5 ) ,Ccr在第 4天 ,第 9天均显著升高 (P <0 .0 1,P <0 .0 5 ) ,BUN在第 4天显著下降 (P <0 .0 1)。和第 4天相比 ,外周血ET在第 9天显著下降 (P <0 .0 5 )。 (2 )在C组 ,和第 1天相比 ,外周血ET在第4天显著升高 (P <0 .0 5 ) ,Ccr在第 4天及第 9天显著下降 (P <0 .0 5 ,P <0 .0 1) ,BUN则无明显改变 (P >0 .0 5 ) ;和第 4天相比 ,外周血ET及Ccr在第 9天均显著下降 (P <0 .0 1)。 (3 )L组门静脉血ET水平显著低于C组 (P <0 .0 1) ,第 4天两组门静脉血ET水平均显著高于外周血ET水平 (P <0 .0 1)。 (4 )L组第
Objective To study the protective effect and mechanism of lactulose on the renal function in acute cholelithiasis with obstructive jaundice. Methods Fifty five cases of acute cholelithotic obstruction were randomly assigned into lactulose group (group L, n=28) and control group (group C, n=27), and 50% lactulose (group L)or 10% glucose (group C ) was administered orally for 3 days before the operation , respectively. The systemic and portal blood endotoxin (ET), blood urea nitrogen (BUN) and endogenous creatinine clearance rate (Ccr) were measured periodically. Results (1) In group L, the level of systemic vein ET and BUN were significantly lower than that in group C (P<0.01,P<0.05), and Ccr (P <0.01) significantly higher on 4d (operation day) and 9d(5 days after operation) than that in group C; compared with on 1d(before medication), the systemic vein ET dropped on 4d and 9d (P<0.05) , Ccr increased on 4d and 9d (P<0.01,P<0.05) and BUN decreased on 4d (P< 0.01 ). (2) In group C, the level of systemic vein ET increased significantly on 4d than that on 1d (P <0.05), Ccr dropped on 4d and 9d (P <0.05,P<0.01) than that on 1d, but BUN showed no significant changes between 1,4 and 9d(P>0.05); and the systemic vein ET and Ccr decreased significantly on 9d (P < 0.01) than that in 4d . (3)The portal vein ET level in group L was significantly lower than that in group C (P<0.01); and on 4d,the portal vein ET in both groups were significantly higher than that in symstemic vein (P<0.01). (4) In group L, the incidences of renal glomerulus and tubule founction impairment were significantly lower that those in group C (P<0.01). Conclusions Lactulose can effectively decrease the level of blood ET in the patients with cholelithotic obstruction, so can ameliorate the impairment of renal function.
出处
《中国普通外科杂志》
CAS
CSCD
2003年第10期761-765,共5页
China Journal of General Surgery
基金
广东省深圳市卫生局资助课题 (9534)
