精氨酸清除率评价梗阻性黄疸时肝储备功能的价值

Evaluation of hepatic function reserve in obstructive status by arginine clearance rate

目的:通过动物实验研究精氨酸清除率(Arg-CR)对肝组织ATP含量的评价能力,探讨其在梗阻性黄疸时评估肝储备功能的价值。方法:24只新西兰兔随机均分为3组,A组和B组开腹结扎胆总管制作梗阻性黄疸模型,分别饲养1周、2周测定Arg-CR,C组(假手术组)仅开关腹,饲养2周测定Arg-CR。所有动物测定术后常规肝功能及肝组织ATP含量。结果:A、B组间常规肝功能检查数值近似且无统计学差异(P>0.05),但A、C组间和B、C组间均有统计学差异(P<0.05)。3组Arg-CR(L/min)分别为3.77±1.10,1.70±0.44和4.27±1.39;肝ATP(mg/dL)分别为4.29±0.68,1.32±1.10和5.78±1.57。A、B和B、C组间Arg-CR和肝ATP均有统计学差异(P<0.05,P<0.01),但A、C组间无统计学差异(P>0.05)。ATP与Arg-CR变化具有一致性,且具有线性相关关系(r=0.7486,P<0.01),但与常规肝功能检查结果不一致。结论:Arg-CR能较好地反映梗阻性黄疸肝脏的ATP水平,可用于评估肝储备功能。

Objective： To assess the efficacy of arginine clearance rate（Arg-CR） test in hepatic function reserve evaluation in obstructive jaundice（OBJ） status by animal experiment.Methods： 24 New Zeland White Rabbits were randomized to 3 groups as A（OBJ 1wks）,B（OBJ 2wks） and C（false surgery）.Obstructive jaundice model were established by common bile duct ligation.All tests were made at the planning time,including common hepatic function test（LFT）,Arg-CR and ATP in liver tissue.Results： LFT between group A and B were similar,but between group A and C,B and C,LFT got statistically differentiation（P〈0.05,P〈0.05）.Arg-CR in 3 groups were 3.77±1.10,1.70±0.44 and 4.27±1.39,respectively,while liver ATP（mg/dL） were 4.29±0.68,1.32±1.10 and 5.78±1.57,respectively.Both of ATP and Arg-CR between group A and B,B and C got statistically differentiation（P〈0.05,P〈0.01）.But between group A and C,neither of them got significant diffierentiation（P〉0.05）.ATP and Arg-CR had linear correlation（r=0.7486,P〈0.01）,but differed with LFT.Conclusion： Arg-CR can be a good index to evaluate the hepatic function reserve in obstructive jaundice.