肝移植受者围手术期性激素的水平对其预后的影响

The change of sex hormone level before and after liver transplantation and its prognostic significance

目的:探讨肝移植受者围手术期性激素的水平对其预后的影响。方法:采集25例原位肝移植受者和10例健康对照者血清标本,采用放射免疫法分析测定血清雌二醇(E2)、睾酮(T)及垂体泌乳素(PRL)水平,严密监测肝移植受者术后肝脏功能、血清性激素水平的变化及受者存活情况,分析性激素水平的变化对肝功能和移植受者死亡率的影响。结果:肝移植受者术前E2和PRL水平明显高于健康对照者,且受者E2和PRL水平随肝功能水平的降低而明显上升;肝移植受者术前T水平明显低于健康对照者,且受者的T水平随肝功能水平的降低而显著下降。术后3周内有20例受者性激素水平恢复正常,其中1例死亡,死亡率为5%;有5例性激素水平未恢复正常,其中3例死亡,死亡率为60%,两组死亡率的比较,差异有统计学意义(P<0.05)。结论:肝移植受者术前血清E2和PRL水平的升高和血清T水平的下降与肝功能水平相关;性激素水平可作为判断肝移植预后的指标。

Objective： To investigate the change of perioperative sex hormone level of liver transplant recipients and evaluate its prognosis. Methods： The level of sex hormone was detected and compared with liver function and survival in 25 patients receiving liver transplantation. Results： Preoperatively, the level of estrodiol （E2） and prolactin （PRL） in liver transplant recipients was significantly higher than in healthy controls, and the level of E2 and PRL in recipients was increased significantly with the decrease of the level of liver function. The preoperative level of testosterone （T） in liver transplant recipients was significantly lower than in healthy controls, and with the decrease of the level of liver function, the level of the recipients＇ testosterone T was significantly decreased. Sex hormone level of 20 recipients returned to normal and 1 recipient died among these recipients with the mortality rate being 5%. Sex hormone level of 5 recipients didn＇ t recover and three of them died with the mortality rate being 60% （P 〈 0.05 ）. Conclusion ： The increase of E2 and PRL levels and the decrease of T level in liver transplant recipients was correlated with worse liver function, and the level of sex hormone can be used as indicator to determine liver transplantation prognosis.