N-乙酰半胱氨酸对重型病毒性肝炎患者血清一氧化氮水平的影响

Effect of N-acetylcystein on serum nitric oxide in patients with fulminant hepatic failure

目的 探讨一氧化氮 (NO)在慢性重型病毒性肝炎 (慢重肝 )早期中的作用以及N 乙酰半胱氨酸 (NAC)治疗重肝对NO水平的影响 ,为重肝提供新的治疗方法。方法 采用夹心酶联免疫吸附法 (ELISA法 )分析 6 5例重肝患者血清NO的水平表达 ,以及动态变化 ;通过NAC治疗组 (2 9例 )与综合治疗组 (36例 )的自身治疗前、后及治疗后两组中疗效的对比 ,观察NAC治疗 30d后对NO水平表达的变化。结果 重肝患者血清NO水平较正常对照组有非常显著性增高。NAC治疗组血清NO自身治疗前、后比较有非常显著性意义。对NAC治疗组NO与SB、PTA相关性分析发现 ,治疗前、后NO与SB改变均呈显著正相关 ,与PTA改变均呈显著负相关。结论 NO水平变化与重肝损伤程度密切相关 ,可作为判定重肝早期指标之一 ;NAC可降低NO水平 ,NAC治疗重肝有效。

OBJECTIVE To determine whether there was a correlation of serum niteic oxide(NO) lever and to assess whether N-acetylcystein (NAC) may affect expression of NO with fulminant hepatic failure(FHF) at earlier stage. METHOD Analysis of serum NO in total of 65 patients were performed by using double antibodies (ELISA).Patients with FHF were grouped into NAC (n =29) and combination therapy(n =36), and then sub-grouped into responsive, non-responsive, based on patients clinical status. Alteration of NO was determined with comparison of self control in these two groups between before NAC treatment and after treatment for 30 days, and control group(n = 30). RESULTS There was a significant increase of serum NO. A significant change of serum NO was found after NAC treatment. NO was correlated positively with SB, and negatively with PTA following the initiation of treatment for 30 days. CONCLUSION The change of serum NO was closely related with hepatic dysfunctions and can offer a reference to the prognosis of patients with FHF at earlier stage. Serum NO level may be declined by NAC. FHF patients may benefit from the use of NAC.