门冬氨酸鸟氨酸对肝硬化肝癌术后肝功能的影响

Effect of L-ornithine-L-aspartate on Liver Fuction after Hemihepatectomy in Patients with Hepatocel-lular Carcinoma and Liver Cirrhosis

目的：观察门冬氨酸鸟氨酸（LOLA）对肝癌合并肝硬化半肝切除术后肝功能的影响。方法：通过随机、对照的方法,将66例肝癌合并肝硬化行半肝切除患者分为2组,仅治疗组于术后1～7 d静脉应用LOLA。全部患者分别在术前及术后1、3、5、7、10、14 d抽外周静脉血检查谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TB）、直接胆红素（DB）。结果：治疗组术后1、3、5 d ALT明显低于对照组（P〈0.05）,术后3、5 d AST明显低于对照组（P〈0.05）。治疗组术后7 d ALT恢复正常的比率高于对照组。LOLA对术后TB、DB无影响。两组术后肝功能不全的发生率无差异（P=0.557）。结论：LOLA能促进肝癌肝硬化半肝切除术后肝脏功能的早期恢复。

Objective To investigate the effect of L-ornithine-L-aspartate on liver fuction after hemihepatectomy in patients with hepatocellular carcinoma and liver cirrhosis. Methods The clinical data of 66 patients receiving hepatectomy were analyzed. The patients were divided into the experimental group（n=33） and control group（n=33）. L-ornithine-L-aspartate was injected intravenously in the experimental group from the 1st to the 7th day after operation. The blood levels of serum alanine aminotransferase（ALT）, aspartic acid aminotransferase（AST）, total bilirubin（TB） and direct bilirubin（DB） were detected at day 1,3,5,7,10,14 after operation. Results In the experimental groupthe levels of AST on 1st3 rd and 5th day and of ALT on 3rd and5 th day after operation were significantly lower in the experimental group than those in the control group（P〈0.05） On the postoperative day 7the ratio of serum ALT in the experimental group returned to normal was significantly higher than that in the control group（P〈0.05） There was no difference between the 2 groups in the levels of TB and DB after operation. The incidence of liver failure after operation was slightly lower in the experimental group than that in the control group（P=0. 557）. Conclusion L-ornithine-L-aspartate can alleviate the hepatic dysfunction after hemihepatectomyand has protective advantage for liver function in the perioperative period of hemihepatectomy.