门冬氨酸鸟氨酸对慢性肝衰竭患者MELD评分的影响

Influence of L-ornithine-L-aspartate on MELD score of patients with chronic liver failure.

目的 探讨门冬氨酸鸟氨酸（LOLA）对慢性肝衰竭（CLF）患者MELD评分和肝功能的影响.方法 2002年5月至2008年11月将我院收治的60例CLF患者根据LOLA的剂量随机分为低剂量组（LD,10 g/d）和高剂量组（HD,20g/d）.比较不同剂量LOLA对患者肝移植术前血氨（NH3）、MELD评分和肝功能的影响.结果 2组患者血NH3的下降幅度分别（62.59±27.87）、（49.36±27.34）μmoL/L,LD组、HD组均有效降低（P均＜0.05）.治疗后2组MELD评分（△MELD）分别降低（8.38±2.24）、（14.57±7.68）分,差异有统计学意义（P＜0.05）.与LD组比较肝脏功能各项指标明显改善,差异均有统计学意义（P均＜0.05）.结论 LOLA能有效地降低CLF患者血NH3水平和MELD评分、改善肝脏功能.

Objective To evaluate the influence of L-ornithine-L-aspartate （LOLA） on model for end stage liver disease（MELD） score and liver function of patients with chronic liver failure （CLF）. Methods Sixty patients consecutively admitted to our hospital from May, 2002 and November, 2008 were enrolled into the study and randomly divided into low dose group （LD group, LOLA：10 g/d） and high dose group （HD group, LOLA ：20 g/d）After treatment of LOLA, the clinical data （ serum NH3 , MELD score and liver function ） were compared between the two groups. Results Compared to serum NH3 level before treatment, serum NH3 decreased （ 62.59 ＋ 27.87 ）μmoL/L in the HD group and （49.36 ＋ 27.34 ） μmol/L in the LD group, and both decreasements were statistical significant （Ps 〈 0. 05 ）. Compared to MELD before treatment, MELD score decreased （ 8.38 ± 2. 24 ） and （ 14.57 ＋ 7.68）, respectively （ Ps 〈 0.05 ）. Compared to LD group, all indices of liver function in the HD group improved more compared to those of the LD group （ Ps 〈 0.05 ）. Compared to LD group, all indices of liver function in the HD group improved more compared to those of the LD group （Ps 〈 0.05 ）. Conclusions LOLA could significantly decrease serum NH3 and MELD score and improve liver function in CLF patients.