复合辅酶对多发伤后继发肝功能损伤的预防性治疗研究

Study on preventive therapy for compound coenzyme on the liver dysfunction induced by multiple trauma

目的观察复合辅酶对多发伤后继发肝功能损伤的影响。方法将多发伤后需再次手术的73例患者分为两组,其中复合辅酶组38例,空白对照组35例,复合辅酶组在常规治疗的同时于术前3 d开始给予复合辅酶2支静脉滴注,每日1次,连续给药10 d,空白对照组仅给予西医常规治疗。监测两组治疗前后肝功能指标:丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)和总胆红素(TBIL)、直接胆红素(DBIL),并比较两组临床疗效。结果复合辅酶组的ALT、AST、TBIL、DBIL分别为(40.5±6.4)U/L、(38.6±7.4)U/L、(18.1±3.5)μmol/L和(5.6±3.1)μmol/L,明显优于空白对照组的(100.8±20.4)U/L、(78.1±15.3)U/L、(45.6±15.4)μmol/L和(29.5±9.1)μmol/L,两组比较差异有高度统计学意义(P<0.01),而ALP、GGT比较差异无统计学意义(P>0.05);复合辅酶组和空白对照组总有效率分别为84.21%和42.85%,两组比较差异有高度统计学意义(P<0.01)。结论复合辅酶对多发伤后继发肝功能损伤有预防作用,可以减少机体对创伤侵袭的反应。

Objective To observe the effect of compound coenzyme on the re-injury of multiple trauma liver function.Methods 73 cases of patients who needed reoperation after multi-injury of liver were divided into 38 cases of compound coenzyme group and 35 cases of control group.The compound coenzyme group was given 2 ampoules of intravenous drip of compound coenzyme in basis of conventional therapy 3 days before the operation,once a day,for 10 days.Patients of the control group were subjected only conventional treatment.The liver functional parameters before and after treatment of the two groups were detected：alanine aminotransferase （ALT）,aspartate aminotransferase （AST）,alkaline phosphatase （ALP）,glutamyltransferase （GGT）,the total bilirubin （TBIL）,direct bilirubin （DBIL）,and the overall efficacy of the two groups were compared.Results Compound coenzyme group of ALT,AST,TBIL,DBIL were （40.5±6.4） U/L,（38.6±7.4） U/L,（18.1 ±3.5） μ mol/L and （5.6±3.1） μmol/L,and control group were （100.8±20.4） U/L,（78.1±15.3） U/L,（45.6±15.4） μmol/L and （29.5±9.1） μmol/L,there were significant differences between the two groups after treatment for 10 days （P 〈 0.01）,while no significant difference was found in ALP and GGT between them （P 〉 0.05）.The overall efficacy ratios were respectively 84.21% and 42.85%,there was a significant difference in curative effect between the two groups （P 〈 0.01）.Conclusion Compound coenzyme can protect the reinjury of liver function and reduce the traumatic reaction for patients with multiple trauma.