肝移植术后危重患者血浆脂质过氧化物的变化及意义

Significance of Changes in plasma lipid peroxide levels in critical lyill patients after liver transplantation

目的 研究肝移植患者术后血浆中脂质过氧化物 (L PO)与术后病情变化的关系。方法 测定了18例肝移植患者术后 2 1d内血浆中 L PO的水平 ,分析其与预后的关系。结果 血浆 L PO在病情明显恶化前有所升高 ,尤其在死亡组患者持续升高 ,其升高的峰值明显高于存活患者 ,血浆 L PO峰值超过 10 μmol/L 的患者死亡几率 (5 /6 )高于血浆 L PO峰值低于 10 μmol/L 的患者 (1/12 ) ,两组病死率差异有显著性意义(P<0 .0 1) ,血浆 L PO日变化率超过 1.2 μmol· L- 1· d- 1的患者死亡几率 (4/5 )高于血浆 L PO日变化率低于 1.2 μmol· L- 1· d- 1的患者 (2 /13) ,两组病死率差异有显著性意义 (P<0 .0 1)。结论 术后检测血浆 L PO对正确判断患者病情危重程度有重要的临床价值 ,可作为常规检查。

Objective To investigate the relationship between plasma lipid peroxide (LPO) levels and prognosis in critically ill patients after liver transplantation. Methods Plasma LPO levels were measured in 18 patients within 21 days after liver transplantation, and their relations to the prognosis were analyzed. Results Plasma LPO levels were markedly elevated in patients before state of illness got severe, especially in those with fatal outcome. The peak LPO levels were much higher in non-survivors than in survivors, and mortality rate in patients whose plasma LPO exceeding 10 μmol/L (5/6 cases) was significantly higher than those under 10 μmol/L (1/12 cases, P<0.01). The mortality rate in patients with daily fluctuation range of plasma LPO levels over 1.2 μmol·L -1·d -1 was higher than those under 1.2 μmol·L -1·d -1, and the difference was significant between two groups (P<0.01). Conclusion Measurement of plasma LPO level might be of clinical significance to properly judge the critically ill conditions, and it can be used as routine examination for patients after liver transplantation.