梗阻性黄疸患者手术前后心钠素及部分体液调节激素变化的研究

Study on ANP and Other Fluid Regulating Hormones' Changes in Obstructive Jaundice before and after Operation

目的 :研究心钠素 (ANP)及其它体液调节激素在梗阻性黄疸手术前后变化及作用机制。方法 :用放射免疫法 ,测定 81例梗阻性黄疸患者手术前后血浆ANP及部分体液调节激素水平。结果 :( 1)梗阻性黄疸患者术前血容量减少 ,而血浆ANP升高 ,手术后血容量增多 ,而血浆ANP下降 ;( 2 )梗阻性黄疸患者术前肾素、醛固酮水平升高 ,术后均下降 ;( 3 )梗阻性黄疸患者内生肌肝清除率术前明显低于正常值 ,术后变化不显著。结论 :( 1)梗阻性黄疸病人心房肌细胞功能亢进 ,解除梗阻可改善心功能 ;( 2 )术后循环血量及电解质失衡可以得到改善 ;( 3 )梗阻性黄疸患者肾功能低下 。

Objective: To study the changes and role of ANP and other fluid regulating hormones in the obstructive jaundice before and after surgical operation. Methods: Eighty-one p atients with obstructive jaundice were investigated before and after t he operation. The levels of atrial natriuretic peptide(ANP)and other fluid-reg ulating hormones were measured by radioimmunoassay. Results: (1)Before the operat ion,patients with obstructive jaundice had a lower plasma volume, bu t increase with plasma ANP.After the operation, patients with obstructive j undice had an increased plasma volume, but decreased plasma ANP. (2) Bef ore the operation, the levels of aldosterone and renin were increased in obs tructive jaundice; after the opertation, the levels of aldosterone and renin were reduced. (3) Before the opertation, the patients with obstructive jaunice had impaired creatinine clearance; after the opertati on, the levels of creatinine clearance were not altered obviously. Conclusion: (1)Heart muscle cells were overactived during obstructive jaundice but ca n be reversed by biliary drainage. (2) The deranged plasma volume?fluid a nd electrolyte in obstructive jaundice can be improved after the operation.(3) R enal functional disturbances were observed in obstructive jaundice which showed little improvement after the operation.