精氨酸对梗阻性黄疸患者内毒素血症的影响

The effect of arginine on endotoxemia in patients with obstructive jaundice

目的 观察精氨酸对梗阻性黄疸 (梗黄 )患者内毒素血症的影响。方法 34例梗黄患者 ,随机分为两组 ,分别在术前给予一般治疗 (阳性对照组 )和一般治疗 +精氨酸治疗 (实验组 ) ,连续治疗 7天 ,观察手术前、后血浆内毒素水平变化 ,并与 2 0例无黄疸的慢性胆囊炎、胆囊结石患者 (空白对照组 )比较。结果 入院时阳性对照组与实验组外周血内毒素水平比较 ,差别无显著意义 (P >0 0 5 ) ,但上述两组内毒素水平均显著高于对照组 (P <0 0 1)。阳性对照组术后第 1天血内毒素水平较术前升高 (P <0 0 5 ) ,7天后下降 ,第 14天接近正常水平 ;治疗组用药后血浆内毒素水平下降 ,术后保持较低水平 ,术后第 7天内毒素已接近正常水平。结论术前使用精氨酸可显著改善梗黄患者内毒素血症。

Objective To observe the effect of arginine on endotoxeamia in patients with obstructive jaundice.Method 34 patients with OJ were randomly divided into general therapy group(OJ group) and arginine therapy group(Arg group),The level of plasma ET(endotoxin) was determined before and after operation,other 20 caces with chronic cholelithiasis without jaundice were employed as the control.Result The plasma ET levels increased significantly in the OJ group and the Arg group than that in the control group at 1st day of hospitalization (P<0.01), however, there was no significant deference between the OJ group and the Arg group.In the OJ group,the plasma ET level increased on 1st day post-operation than pre-operation(P<0.05),ET began to decrease one week later and approached to normal on 14th day post-operation.In the Arg group,the plasma ET level decreased significantly after arginine treatment and approached to normal on 7th day postoperation.Conclusion Arginine could decrease the endotoxin level in patients with OJ.