肾移植患者术后肝功能变化规律

The changing rules of liver function in the post-renal transplant patients

目的探讨肾移植患者术后肝功能变化的规律及特点。方法收集郑州市第七人民医院2011年1月至2015年1月接受肾移植手术的103例患者的临床资料,采用回顾性分析探讨术前及术后第1、2、3周和第1、2、3、12月相关生化指标[谷氨酰转肽酶(GGT)、谷丙转氨酶(ALT)、碱性磷酸酶(ALP)、谷草转氨酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)]的变化规律。结果肾移植患者术后第1周ALT、TBil、DBil和IBil水平高于术前,差异有统计学意义(P<0.05);术后第2周ALP、GGP、TBil、DBil和IBil水平高于术前,差异有统计学意义(P<0.05);术后第3周仅TBi L指标高于术前,差异有统计学意义(P<0.05);术后第1月ALP水平高于术前,差异有统计学意义(P<0.05);术后第3月,ALT、GGT、AST水平高于术前,差异有统计学意义(P<0.05);术后第12月7项指标水平与术前比较,差异无统计学意义(P>0.05)。结论检测ALT、AST、ALP、GGP、TBIL、DBIL和IBIL指标可反应肾移植术后肝功能状态,对发现及预防肝脏并发症具有重要意义。

Objective To observe the changing rules and characteristics of liver function in the post-renal transplant patients. Methods The clinical data of 103 patients with renal transplantation were collected from January of 2011 to January of2015 in the Seventh People ＇s Hospital of Zhengzhou. The changing rules of biochemical indexes included gamma glutamyl transpeptidase（ GGP）,alanine aminotransferase（ ALT）,alkaline phosphatase（ ALP）,aspertate aminotransferase（ AST）,total bilirubin（ TBIL）,direct bilirubin（ DBIL） and indirect bilirubin（ IBIL） were assessed before and after kidney transplantation surgery. Results The levels of ALT,TBil,DBil and IBil in the first week after operation were higher than those before operation（ P〈0. 05）. The levels of ALP,GGP,TBil,DBil and IBil in the second week after operation were higher than before the operation,and the difference was statistically significant（ P〈0. 05）. In the third week after operation,the level of TBi L was higher than that before operation,and the difference was statistically significant（ P〈0. 05）. One month after operation,The level of ALP level was higher than that before operation（ P〈0. 05）. Two months after operation,the levels of ALT,GGT and AST were higher than those before operation,and the difference was statistically significant（ P〈0. 05）. There were no significant differences of the 7 indexes between 12 months after operation and before operation（ P〈0. 05）. Conclusion Detection of ALT,AST,ALP,GGP,TBIL,DBIL and IBIL indexes can reflect the liver function after renal transplantation,of great significance to the discovery and prevention of liver complications.