脾切断流术对肝硬化门静脉高压患者肝功能及血清HGF、TGF-β的影响

Effect of Splenectomy and Derascularization on the Liver Function, Serum HGF and TGF-β of Patients with Cirrhosis and Portal Hypertension

目的探讨脾切断流术对肝硬化门静脉高压患者肝功能及血清HGF、TGF-β水平的影响。方法方便选取2013年3月—2015年12月该院收治的肝硬化门静脉高压患者98例,随机分为对照组与观察组,各49例。对照组给予保守治疗,观察组行脾切断流术治疗。检测2组血清总胆红素(T-Bil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)及前白蛋白(PA)等肝功能指标水平及HGF、TGF-β水平,评价治疗前后患者肝功能状态及血清HGF、TGF-β水平的变化。结果治疗前2组各项肝功能指标及血清HGF、TGF-β水平比较差异无统计学意义(P>0.05);与治疗前比较,治疗后观察组T-Bil(27.59±7.22)μmol/L,AST(46.19±7.66)IU/L,ALT(38.79±8.27)IU/L,ALP(56.25±13.25)U/L等肝功能指标及TGF-β水平(92.28±12.63)μg/L降低,而PA(107.26±10.33)mg/L,HGF(7.55±1.86)μg/L水平升高,且组间差异有统计学意义(P<0.01)。结论脾切断流术可显著提高肝硬化门静脉高压患者血清HGF水平,降低血清TGF-β水平,改善患者肝功能。

Objective To study the effect of splenectomy and portal-azygos disconnectior on the liver function, serum HGF and TGF-β of patients with cirrhosis and portal hypertension. Methods Convenient selection 98 cases of patients with cirrhosis and portal hypertension admitted and treated in our hospital from March 2013 to December 2015 were selected and randomly divided into two groups with 49 cases in each, the control group adopted the conservative treatment, while the observation group adopted the splenectomy and portal-azygos disconnectior treatment, and the T-Bil, ALT, AST, ALP and PA and HGF and TGF-β levels of the two groups were tested, and the liver function state and serum HGF and TGF-β level changes before and after treatment were evaluated. Results Before treatment, there were no obvious differences in the liver function indexes and serum HGF and TGF-β levels between the two groups（P〉0.05）, the T-Bil, AST, AL, ALP and TGF-β levels of the observation group after treatment were respectively（27.59±7.22）μmol/L,（46.19±7.66）IU/L,（38.79±8.27）IU/L,（56.25±13.25）U/L,（92.28±12.63）μg/L, which decreased compared with those before treatment, but the PA and HGF were respectively（107.26±10.33）mg/L and（7.55±1.86）μg/L, and the differences between groups were obvious（P〈0.01）. Conclusion The splenectomy and portal-azygos disconnectior can obviously improve the serum HGF level of patients with cirrhosis and portal hypertension, reduce the serum TGF-β level and improve the liver function of patients.