肺移植围手术期肝肾功能动态分析

Dynamical analysis of liver and kidney function during lung transplantation

目的观察肺移植围手术期肝肾功能变化情况和探讨其对临床急性排斥反应(acuterejection,AR)时诊断治疗的参考价值。方法分别对2例接受同一供者的左、右肺肺移植患者,移植前后血清中总胆红素(TBIL)、丙氨酸转氨酶(ALT)和肌酐(CRE)的变化情况进行动态观察分析。结果TBIL在使用环孢素(CSA)期间有不同程度升高,AR得到控制时可恢复正常;ALT在病情恶化时异常增高;CRE变化不大。结论TBIL可以作为肺移植术后免疫抑制药物CSA肝毒性的敏感指标;ALT的异常变化可作为病程转归的指标。

Objective To observe the variety of liver and kidney function during lung transplan ration and discuss its reference value of diagnosis and therapy in clinical acute rejection（AR）. Methods The variety of TBIL, ALT and CRE were dynamically studied and analyzed before and after lung transplantation in 2 cases shared one same donor＇s lung block. Results During the use of CSA, TBIL diversely procedurally raised and it got right when AR was under control; when illness was worsen, ALT abnormally raised and CRE had no remarkably change, Conclusion TBIL is the sensitivity index of hepatotoxicity of immunity inhibitor CSA after lung transplantation. The abnormal change of ALT is the index of disease turnover.