综合驱铜治疗对肝豆状核变性患者胆汁排铜及肝脾声像图的影响

Impact of synthetucal copper-binding therapy on the biliary copper excretion and hepatolienal ultrasonography of hepatolenticular degeneration

为了探讨综合驱铜治疗对具有不同肝脾声像图分型的肝豆状核变性 ( HLD)患者胆汁排铜及肝脾声像图指标的影响。我们采用二巯丁二酸和二巯丙磺钠治疗 30例 HLD,治疗前后用 Aloka SSD2 56型声像图仪对患者进行声像图分型和测量 ,并施行 12指肠引流术留取胆汁 B液检测铜、锌、铁含量。结果综合驱铜能有效地增加光点闪烁型、岩层征型和树枝状光带型患者的胆汁铜排泄 ( P<0 .0 0 1) ,且树枝状光带型的 SPT、SPLb、SV、PV较疗前显著改善 ( P<0 .0 1) ,而结节型患者胆汁铜排泄未见明显改善 ,仅疗后 SV、PV有显著性改善 ( P<0 .0 5)。认为综合驱铜能明显地促进肝硬化前期及早、中期 HLD患者肝胆铜排泄 。

The aim of our study was to observe changes of biliary trace elements and hepatolienal ultrasonography in patients with HL D treated synthetically by metal-binding a- gents DMSA and DMPS.Using Aloka SSD2 5 6 ultrasonography and WFX-1 E2 atomic ab- sorption spectrophotometer,we analysed and asseyed the sonograms and biliary trace ele- ments of30 patients with differentultrasonographic typesbefore and six weeksafter DMSA and DMPS treatment.Biliary B juice were obtained by duodenal drainage.The results showed that the biliary copper content of patients with glinting echogenic dots type,rock stratum type and tree-like type increaed markedly after therapy(P<0 .0 0 1 ) ,copper excre- tion of patients with nodular type didn t reveal any statistically significant changes.SPT, SPL b,SV,PV of patients with tree-like type and SV,PV of patients with nodular type im- proved obviously(P<0 .0 1 ,P<0 .0 5 respectively) .Itindicated thatsynthetical copper-bind- ing therapy could increase effectively the biliary copper excretion of patients in the precir- rhotic stage and early or middle stage of cirrhosis,and improve obviously the ultrasonic in- dexes related to hepatocirrhosis.