Prostaglandin E1 administration post liver transplantation and renal outcomes:A retrospective single center experience

BACKGROUND Prostaglandin E1(PGE1),or alprostadil,is a potent vasodilator that improves hepatic blood flow and reduces ischemia-reperfusion injury post-liver transplantation(LT).However,the benefits of PGE1 on renal function after LT have not yet been well described.AIM To assess the impact of PGE1 administration on renal function in patients who underwent liver or liver-kidney transplant.METHODS This retrospective study included all patients who underwent liver or liverkidney transplant at our institution from January,2011 to December,2021.Patients were classified based on whether they received PGE1.PGE1 was administered post-LT to those with transaminases>1000 U/L in the immediate postoperative period.Demographics,post-LT treatments and/or complications,renal function,and survival were analyzed.Multivariable logistic regression analysis was performed,and a two-tailed P value<0.05 was considered statistically significant.RESULTS A total of 145 patients underwent LT,with 44(30%)receiving PGE1.Baseline patient characteristics were comparable,except the PGE1 group had significantly higher aspartate aminotransferase(AST)(1961.9 U/L±1862.3 U/L vs 878 U/L±741.4 U/L,P=0.000),alanine aminotransferase(1070.6 U/L±895 U/L vs 547.7 U/L±410 U/L,P=0.000),international normalized ratio on post-LT day 1(2±0.74 vs 1.8±0.4,P=0.03),a longer intensive care unit stay(8.1 days±11.8 days vs 3.8 days±4.6 days,P=0.003),more vasopressor use(55.53 hours±111 hours vs 16.33 hours±26.3 hours,P=0.002),and higher immediate postoperative complications(18.6%vs 4.9%,P=0.04).The PGE1 group also had a significantly higher 90-day readmission rate(29.6%vs 13.1%,P=0.02)and lower 1-year liver graft survival(87.5%vs 98.9%,P=0.005).However,30-day readmission(31.6%vs 27.4%,P=0.64),LT complications(hepatic artery thrombosis,biliary complications,rejection of liver graft,cardiomyopathy),1-year patient survival(96.9%vs 97.8%,P=0.77),overall liver graft survival,and overall patient survival were similar between the two groups(95.4%vs 93.9%,P=0.74 and 88.4%vs 86.9%,P=0.81 respectively).Although the PGE1 group had a significantly lower glomerular filtration rate(eGFR)on post-LT day 7(46.3 mL/minute±26.7 mL/minute vs 62.5 mL/minute±34 mL/minute,P=0.009),the eventual need for renal replacement therapy(13.6%vs 5.9%,P=0.09),the number of dialysis sessions(0.91 vs 0.27,P=0.13),and eGFR at 1-month(37.2 mL/minute±35.9 mL/minute vs 42 mL/minute±36.9 mL/minute,P=0.49),6-months(54.8 mL/minute±21.6 mL/minute vs 62 mL/minute±21.4 mL/minute,P=0.09),and 12-months(63.7 mL/minute±20.7 mL/minute vs 62.8 mL/minute±20.3 mL/minute,P=0.85)post-LT were similar to those in the non-PGE1 group.CONCLUSION In patients who received PGE1 for ischemia-reperfusion injury,despite immediate acute renal injury post-LT,the renal function at 1-month,6-months,and 12-months post-LT was similar compared to those without ischemiareperfusion injury.Prospective clinical trials are needed to further elucidate the benefits of PGE1 use in renal function.

Cyclooxygenase-2 expression is associated with initiation of hepatocellular carcinoma, while prostaglandin receptor-1 expression predicts survival

AIM to determine whether cyclooxygenase-2(COX-2) and prostaglandin E1 receptor(EP1) contribute to disease and whether they help predict prognosis.METHODS We retrospectively reviewed the records of 116 patients with hepatocellular carcinoma(HCC) who underwent surgery between 2008 and 2011 at our hospital. Expression of COX-2 and EP1 receptor was examined by immunohistochemistry of formalin-fixed, paraffinembedded tissues using polyclonal antibodies. Possible associations between immunohistochemical scores and survival were determined.RESULTS Factors associated with poor overall survival(OS) were alpha-fetoprotein > 400 ng/m L, tumor size ≥ 5 cm, and high EP1 receptor expression, but not high COX-2 expression. Disease-free survival was not significantly different between patients with low or high levels of COX-2 or EP1. COX-2 immunoreactivity was significantly higher in well-differentiated HCC tissues(Edmondson grade Ⅰ-Ⅱ) than in poorly differentiated tissues(Edmondson grade Ⅲ-Ⅳ)(P = 0.003). EP1 receptor immunoreactivity was significantly higher in poorly differentiated tissue than in well-differentiated tissue(P = 0.001).CONCLUSION COX-2 expression appears to be linked to early HCC events(initiation), while EP1 receptor expression may participate in tumor progression and predict survival.

EFFECTS OF PROSTAGLANDIN E1 ON THE PROGRESSION OF ARISTOLOCHIC ACID NEPHROPATHY

Objective To investigate the effects of prostaglandin E1 (PGE1) on the progression of aristolochic acid nephropathy (AAN). Methods Twenty-four patients diagnosed as AAN with serum creatinine (Scr) between 1.5 mg/dL and 4 mg/dL during September 2001 to August 2003 were randomly divided into 2 groups. All patients had ingested long dan xie gan wan con-taining aristolochic acid (0.219 mg/g) for at least 3 months. Twelve patients were injected with Alprostadil (10 μg/d for 10 days in one month, summing up to 6 months). Except for PGE1, the other therapy was same in both groups. Renal function was assessed using reciprocal serum creatinine levels (1/Scr). Results The level of Scr and serum hemoglobin (Hgb) was similar in both groups prior to therapy. During follow-up, 1/Scr levels in PGE1 group were significantly higher than control group (P < 0.01), and Hgb levels in PGE1 group were sig-nificantly increased compared with control (P < 0.05).Conclusion PGE1 can slow the progression of renal failure and increase Hgb level of AAN patient.

Protective effects of prostaglandin E1 perfusion againstspinal cord ischemia-reperfusion injury in a rabbit model

BACKGROUND： Prostaglandin E1 （PGE1） is known to be protective in ischemia-reperfusion of heart, lung,renal, and liver tissue. It still remains to be determined whether PGE1 exhibits similar protection against spinal cord ischemia-reperfusion injury in a rabbit model. OBJECTIVE： To observe the large, ventral horn, motor neurons of the spinal cord, as well as limb function, and to investigate whether perfusion of PGE1 exhibits protective effects against spinal cord ischemia-reperfusion injury in a rabbit model. DESIGN, TIME AND SETTING： Controlled observation. The experiment was performed at the Department of Orthopedics, First Affiliated Hospital of Liaoning Medical University between June and October 2007. MATERIALS： Twenty male, New Zealand white rabbits, weighing 2.0 kg and of mixed gender, were used in the present study. The following chemicals and compounds were used： prostaglandin E1 injectable powder,as well as malondialdehyde and ATPase kits. Animal intervention was in accordance with animal ethical standards. METHODS： We separated rabbits into control and experimental groups randomly, with 10 rabbits in each group. Rabbits were used as spinal cord ischemia models by segmentally cross-clamping the infrarenal aorta. The control group was subsequently perfused for five minutes with blood and saline solution, and the experimental group was perfused for 5 minutes with blood and saline solution containing PGE1 （100 ng/kg/min）. MAIN OUTCOME MEASURES： The neurological function of the hind limbs was assessed 12, 24, and 48 hours after model establishment. All animals were sacrificed and spinal cords were harvested for histological analyses. The large motor neurons in the ventral horn of L1-7 were observed by inverted microscope. RESULTS： All 20 rabbits were included in the final analysis, without any loss. In the ventral horn of the L5-7 segments, there were more large motor neurons that appeared viable in the experimental group than the control group （P 〈 0.05）. The scores of hind limb functions were greater in the experimental group after 12, 24, and 48 hours （P 〈 0.01）. CONCLUSION： Perfusion of PGE1 reduced the amount of neuronal damage in the spinal cord ischemia-reperfusion injury rabbit model. These results correlated with increased numbers large motor neurons in the ventral horn of the spinal cord, as well as improved hind limb function.

Does perioperative prostaglandin E1 affect survival of patients with esophageal cancer?

AIM: To detect the effect of intraoperative prostaglandin E1 (PGE1) infusion on survival of esophagectomized patients due to cancer. METHODS: In this preliminary study, a double blinded placebo based clinical trial was performed. Thirty patients with esophageal cancer scheduled for esophagectomy via the transthoracic approach were randomized by a block randomization method, in two equal groups: PGE1 group - infusion of PGE1 (20 ng/kg per minute) in the operating room and placebo group - saline 0.9% with the same volume and rate. The infusion began before induction of anesthesia and finished just before transfer to the intensive care unit. The patients, anesthetist, intensive care physicians, nurses and surgeons were blinded to both study groups. All the patients were anesthetized with the same method. For postoperative pain control, a thoracic epidural catheter was placed for all patients before induction of anesthesia. We followed up the patients until October 2010. Basic characteristics, duration of anesthesia, total surgery and thoracotomy time, preoperative hemoglobin, length of tumor, grade of histological differentiation, disease stage, number of lymph nodes in the resected mass, number of readmissions to hospital, total duration of readmission and survival rates were compared between the two groups. Some of the data originates from the historical data reported in our previous study. We report them for better realization of the follow up results. RESULTS: The patients’ characteristics and perioperative variables were compared between the two groups. There were no significant differences in age (P = 0.48), gender (P = 0.27), body mass index (P = 0.77), American Society of Anesthesiologists physical status more than?I?(P = 0.71), and smoking (P = 0.65). The PGE1 and placebo group were comparable in the following variables: duration of anesthesia (277 ± 50 vs 270 ± 67, P = 0.86), duration of thoracotomy (89 ± 35 vs 96 ± 19, P = 0.46), duration of operation (234 ± 37 vs 240 ± 66, P = 0.75), volume of blood loss during operation (520 ± 130 vs 630 ± 330, P = 0.34), and preoperative hemoglobin (14.4 ± 2 vs 14.7 ± 1.9, P = 0.62), respectively. No hemodynamic complications requiring an infusion of dopamine or cessation of the PGE1 infusion were encountered. Cancer variables were compared between the PGE1 and placebo group. Length of tumor (11.9 ± 3 vs 12.3 ± 3, P = 0.83), poor/undifferentiated grade of histological differentiation [3 (20%) vs 3 (20%), P = 0.78], disease stage III [5 (33.3%), 4 (26.7%), P = 0.72] and more than 3 lymph nodes in the resected mass [3 (20%) vs 2 (13.3%), P = 0.79] were similar in both groups. All the patients were discharged from hospital except one patient in the control group who died because of a post operative myocardial infarction. No life threatening postoperative complication occurred in any patient. The results of outcome and survival were the same in PGE1 and placebo group: number of readmissions (2.1 ± 1 vs 1.9 ± 1, P = 0.61), total duration of readmission (27 ± 12 vs 29 ± 12, P = 0.67), survival rate (10.1 ± 3.8 vs 9.6 ± 3.4, P = 0.71), overall survival rate after one year [8 (53.3%) vs 7 (47%), P = 0.72], overall survival rate after two years [3 (20%) vs 3 (20%), P = 0.99], and overall survival rate after three years [0 vs 1 (6.7%), P = 0.99], respectively. CONCLUSION: In conclusion, PGE1 did not shorten or lengthen the survival of patients with esophageal cancer. Larger studies are suggested.

The effect of prostaglandin E_1 on recovery of early renal graft functions after transplantation

Objective To investigate the effect of prostaglandin E1 (PGE1) on recovery of early renal graft functions after transplantation. Methods One hundred and seven patients after renal transplantation were allocated in the treated group, and treated by conventional treatment with injection of 10 μg prostaglandin E1 additionally twice a day for 14 days. And eighty-eight patients who received conventional treatment alone after renal transplantation at the corresponding period were allocated in the control group. Indexes of the two groups, including incidence of delayed graft function and acute rejection reaction, volume of urine, serum certaintie (SCr), endogenous certainties clearance rate (CCr), the blood flow resistance in graft as well as blood viscosity (BV), and platelet aggregation rate (PAR), were determined. Results The urinary volume and endogenous certainties clearance rate of the treated group were significantly higher, but the level of SCr, incidence of renal function recovery retardation, BV, PAR and blood flow resistance in graft were significantly lower than those of the control group (P<0.05). The difference of incidence of acute rejection reaction between the two groups was insignificant (P>0.05). Conclusion Prostaglandin E1 can improve blood microcirculation and decrease the incidence of renal function recovery retardation. These effects are helpful for recovery of renal function after renal transplantation.

Intra-arterial lipo-prostaglandin E1 infusion for arterial spasm in liver transplantation:A case report

BACKGROUND Hepatic artery obstruction is a critical consideration in graft outcomes after living donor liver transplantation.We report a case of diffuse arterial vasospasm that developed immediately after anastomosis and was managed with an intra-arterial infusion of lipo-prostaglandin E1(PGE1).CASE SUMMARY A 57-year-old male with hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma underwent ABO-incompatible living donor liver transplant.The grafted hepatic artery was first anastomosed to the recipient’s right hepatic artery stump.However,the arterial pulse immediately weakened.Although a new anastomosis was performed using the right gastroepiploic artery,the patient’s arterial pulse rate remained poor.We attempted angiographic intervention immediately after the operation;it showed diffuse arterial vasospasms like‘beads on a string’.We attempted continuous infusion of lipo-PGE1 overnight via an intra-arterial catheter.The next day,arterial flow improved without any spasms or strictures.The patient had no additional arterial complications or related sequelae at the time of writing,1-year post-liver transplantation.CONCLUSION Angiographic evaluation is helpful in cases of repetitive arterial obstruction,and intra-arterial infusion of lipo-PGE1 may be effective in treating diffuse arterial spasms.

前列腺素E_1对犬缺血心肌的保护作用

目的：探讨前列腺素Ｅ１（ＰＧＥ１）对缺血心肌的保护作用。方法：将２０只左冠状动脉前降支（ＬＡＤ）结扎犬分成２组（每组各１０只），Ⅰ组在ＬＡＤ结扎后静滴ＰＧＥ１，Ⅱ组静滴生理盐水作为对照组。２组犬均于ＬＡＤ结扎前，结扎后３０分钟、４小时、２４小时和４８小时采集周围静脉血，检测血浆血小板表面α颗粒膜蛋白（ＧＭＰ１４０）和血栓素Ｂ２（ＴＸＢ２）含量；ＬＡＤ结扎４８小时后处死动物，取出心脏检测心肌组织内髓过氧化物酶（存在于中性粒细胞颗粒中）活性，并将心肌切片后行氯化三苯基四氮唑（ＴＴＣ）染色，确定梗塞面积大小。结果：２组犬ＬＡＤ结扎后３０分钟血浆ＧＭＰ１４０和ＴＸＢ２含量〔Ⅰ组：（４５．０±１８．７）μｇ／Ｌ，（１７２．０±７２．５）ｎｇ／Ｌ；Ⅱ组：（４７．０±１８．６）μｇ／Ｌ，（１９５．０±７５．４）ｎｇ／Ｌ〕均高于结扎前〔Ⅰ组：（２１．０±１０．４）μｇ／Ｌ，（１２６．０±５５．１）ｎｇ／Ｌ；Ⅱ组：（２０．０±９．５）μｇ／Ｌ，（１２３．０±５６．２）ｎｇ／Ｌ〕；２组间无显著差异。Ⅰ组犬ＬＡＤ结扎后４小时ＧＭＰ１４０和ＴＸＢ２较结扎后３０分钟时不再继续升高，至４８小时后两者恢复至结扎前水平。Ⅱ组犬ＬＡＤ结扎后?

PGE_1对培养乳鼠心肌细胞缺氧/复氧损伤的保护作用

目的 研究PGE1对纯化培养心肌细胞缺血再灌注损伤的保护作用及机制。方法 采用纯化培养的心肌细胞建立缺氧 /复氧损伤模型 ,实验分 5组 :正常细胞培养组、缺氧 /复氧损伤模型组、缺氧 /复氧损伤 +PGE1(5、15、4 5 μg·L-1)组。分别用黄嘌呤氧化酶法测定SOD活力 ,硫代巴比妥酸显色法测定MDA含量 ,MTT染色法测定线粒体脱氢酶活性改变并测定LDH含量变化。结果 PGE1可明显提高SOD、LDH活性 ,降低MDA含量并可提高线粒体脱氢酶活性。结论 PGE1具有明显的抗缺氧复氧损伤。

前列腺素E_1对脑缺血再灌注损伤的保护作用

目的 探讨前列腺素E1 (PGE1 )在脑缺血再灌注损伤中对脑组织过氧化的影响、对脑细胞膜ATP酶的保护、对血浆炎性细胞因子及内皮素的干预作用。方法 采用线栓法阻断大鼠左侧大脑中动脉 ,造成局灶性脑缺血再灌注模型 ,用药组于缺血前 5minivgttPGE1 (1 2 ,2 4 ,48μg·kg- 1 ) ,模型组及假手术组给予等容积NS。各组在大脑中动脉阻塞(MCAO) 60min ,再灌注 60min后 ,断头、取脑匀浆 ,测定其丙二醛 (MDA)含量 ,总超氧化物歧化酶 (SOD)活性 ,谷胱甘肽过氧化物酶 (GSH Px)活性及Na+ ,K+ ATP酶 ,Ca2 + ATP酶 ,Mg2 + ATP酶活性。心脏取血分离血浆测定其肿瘤坏死因子 (TNFα)的浓度及白介素 (IL 1 β、IL 6)和血浆内皮素 (ET 1 )的含量。结果 缺血再灌注模型组与假手术组相比 ,MDA含量升高 (P <0 0 5)、SOD及GSH Px活力降低 (P<0 0 5) ,Na+ ,K+ ATP酶、Ca2 + ATP酶、Mg2 + ATP酶活性降低 (P <0 0 5) ,TNFα、IL 1 β、ET 1含量升高 (P <0 0 5)。PGE1 3剂量组与模型组相比 ,MDA含量降低 (P <0 0 5) ,SOD及GSH Px活力升高 (P <0 0 5) ,Na+ ,K+ ATP酶、Ca2 + ATP酶、Mg2 + ATP酶活性升高 (P <0 0 5 ) ,Mg2 + ATP酶活性亦升高 ,TNFα、IL 1 β、ET 1含量降低 (P<0 0 5)。结论 PGE1 对缺血再灌注?

前列腺素E_1对缺氧复氧乳鼠心肌细胞凋亡的影响

目的 探讨PGE1对缺氧复氧乳鼠心肌细胞凋亡的影响及其作用机制。方法 用原代培养的乳鼠心肌细胞建立缺氧 3 0min复氧 40min损伤模型 ,DNA琼脂糖凝胶电泳和原位末端标记技术 (TUNEL)检测缺氧复氧乳鼠心肌细胞的凋亡 ,原位杂交法检测bcl 2、baxmRNA的含量。结果 模型组乳鼠心肌细胞DNA琼脂糖凝胶电泳呈明显的梯状图谱 ,TUNEL法检测到较多的阳性标记 ,PGE1各给药组随剂量的增加 ,电泳中的DNA梯状条带逐渐减弱 ,PGE1(0 12 7μmol·L- 1)组心肌细胞的凋亡率 (6 80 %± 1 99% )与模型组 (11 40 %± 2 3 2 % )相比差异有统计学意义 (P <0 0 1) ;模型组与正常组相比bcl 2mRNA的含量下降、baxmRNA的含量增加 ,PGE1各给药组与模型组相比能明显的上调bcl 2mRNA的含量、下调baxmRNA的含量。结论 离体培养的乳鼠心肌细胞建立的缺氧复氧损伤模型可诱导心肌细胞的凋亡。PGE1可明显抑制这种凋亡的发生 ,其机制可能与促进bcl 2mRNA的表达。

内毒素致家兔急性肺损伤时肺和肺外脏器的病理组织学变化及东莨菪碱和前列腺素E_1的保护作用

目的：了解内毒素血症时各脏器受损的病理组织学变化及东莨菪碱和前列腺素Ｅ１的保护作用。方法：大耳白兔５０只，随机分为５组：Ａ组为对照组；Ｂ组为内毒素致伤组（７００μｇ／ｋｇ）；Ｃ组、Ｄ组分别为内毒素致伤后东莨菪碱和前列腺素Ｅ１治疗组，Ｅ组为东莨菪碱和前列腺素Ｅ１联合治疗组。实验前及实验后０．５、２、４和６小时分别测血压和呼吸频率；实验后６．５小时放血处死动物，测肺毛细血管通透指数，同时取肺、心、脑、肝、肾、肾上腺和脾组织作光镜及电镜检查。结果：Ｂ组动物全部于实验后０．５小时出现休克和呼吸困难；６．５小时测得的肺毛细血管通透指数显著高于对照组，各脏器的病理组织学改变以肺最为明显且严重。各治疗组肺受损均轻于Ｂ组，其它脏器在实验后６．５小时的病理变化不明显。结论：内毒素休克时，肺是敏感且最早受损的脏器；东莨菪碱和前列腺素Ｅ１联合治疗组的疗效基本与两药单独治疗组相同。

前列腺素E_1抑制血管平滑肌细胞增殖的作用

目的 从细胞周期蛋白和凋亡相关基因探讨前列腺素E1(PGE1)对血管平滑肌细胞 (VSMC)增殖的调控作用。方法 采用培养的新生牛主动脉VSMC ,以胎牛血清及白介素 1(IL 1)分别作为促增殖剂 ,测定不同浓度PGE1对VSMC增殖、细胞内周期蛋白d1mRNA表达、p5 3及Bcl 2基因表达和培养液内NO含量的影响。结果 PGE1浓度依赖性抑制胎牛血清促VSMC增殖作用 ;显著减少细胞周期蛋白d1mRNA含量 ;浓度依赖性诱导IL 1孵育下VSMC产生大量NO ,同时抑制VSMC增殖 ;并促进p5 3基因表达 ,下调bcl 2基因 ,诱导细胞凋亡。结论 PGE1具有抑制VSMC增殖的作用 ,其机制可能与其阻滞VSMC生长有关 ;在炎性因子存在情况下 ,PGE1可诱导VSMC内大量产生NO ,抑制VSMC增殖 ,并加速VSMC凋亡。

前列腺素E_1治疗带状疱疹后遗神经痛临床试验研究

目的研究前列腺素E1脂微球载体制剂(LipoPGE1,凯时)治疗顽固性带状疱疹后遗神经痛的疗效及不良反应。方法按随机对照原则将持续疼痛1个月以上的带状疱疹后遗神经痛患者分为对照组(A组)和试验组(B组),除了同时应用曲马多缓释胶囊治疗外,对照组采用静脉封闭疗法,而试验组则采用LipoPGE1治疗。结果试验组加用LipoPGE1治疗1周后,疼痛明显缓解,总有效率达95%,对照组有效率仅达60%,但两者秩和检验差异无显著性的意义(P>0.01)。治疗后2、4和8周随访,试验组的显效率和治愈率明显优于对照组,且秩和检验在统计学上差异有非常显著的意义(P<0.01)。结论LipoPGE1是治疗顽固性带状疱疹后遗神经痛的有效且安全的药物。

前列腺素E_1对慢性乙型肝炎肝功能和肝纤维化指标的影响

本文应用前列腺素E1治疗慢性乙肝患者 2 8例 ,分别于治疗前和治疗结束时抽血查血清谷丙转氨酶(GPT)、血清总胆红素 (TBIL)、血清总胆汁酸 (TBA)、透明质酸 (HA)和前Ⅲ型胶原 (PCⅢ )。治疗 1个月后 ,观察组GPT ,TBIL ,TBA ,HA及PCⅢ治疗前后相比差异具有显著性 (P <0 .0 5 ) ,和对照组相比差异也具有显著性 (P <0 .0 5 )。提示PGE1能明显改善慢性乙肝患者肝功能 ,并具有一定的抗肝纤维化作用。

前列腺素E_1对先心病重度肺动脉高压患者肺组织结构的影响

选择 2 8例先心病重度肺动脉高压患者 ,在应用前列腺素 E1 (PGE1 )前后行肺组织活检术 ,光镜下观察肺小动脉组织结构及其变化特点。用法 :PGE1 15～ 2 5 ng/ (kg·min)持续静滴 ,每天用药 10～ 12 h,14 d为 1疗程。结果示有 2 6例患者的肺组织结构明显改善 ,病理损害减轻 ,其他 2例无变化。认为应用 PGE1 治疗能够改善肺组织结构 ,使病情减轻 。

前列腺素E_1降低糖尿病肾病患者血浆内皮素水平

目的 :研究静脉输注前列腺素E1(PGE1)对 2型糖尿病患者血浆内皮素 (ET)水平影响。观察PGE1治疗 /ACEI治疗对糖尿病蛋白尿的影响。方法 :观察PGE1治疗组、ACEI治疗及普通治疗组对糖尿病蛋白尿水平的疗效 ,并对前列腺素E1治疗前后糖尿病患者血浆内皮素水平进行检测。结果 :糖尿病患者血浆内皮素水平明显高于正常对照组。静脉输注PGE1可显著降低糖尿病患者血浆内皮素水平。PGE1可显著降低糖尿病患者蛋白尿水平 ,效果明显高于ACEI治疗组 ,而后者疗效又显著高于非ACEI治疗组。结论 :PGE1可显著降低糖尿病患者蛋白尿水平 ,此作用可能与降低糖尿病患者血浆内皮素水平有关。

气管内应用脂质体前列腺素E_1对油酸致大鼠急性肺损伤的保护作用

目的：探讨气管内应用脂质体携载的前列腺素Ｅ１（ＬｉｐＰＧＥ１）对油酸致大鼠急性肺损伤的保护作用及其机制。方法：Ｗｉｓｔａｒ大鼠４０只，随机均分为５组：正常对照组、油酸致伤组、ＬｉｐＰＧＥ１组、游离前列腺素Ｅ１（ＦＰＧＥ１）组和空白脂质体（ＰＬｉｐ）组。观察肺系数、肺湿重／干重比、肺组织碱性磷酸酶（ＡＬＰ）、血管紧张素转换酶（ＡＣＥ）、髓过氧化酶（ＭＰＯ）的活性和丙二醛（ＭＤＡ）含量的变化。结果：与油酸损伤组比较，ＬｉｐＰＧＥ１组的肺系数、肺组织湿重／干重比与ＭＰＯ活性、ＭＤＡ水平明显降低，而ＡＬＰ与ＡＣＥ活性显著提高；ＬｉｐＰＧＥ１的作用显著优于ＦＰＧＥ１；ＰＬｉｐ无效。结论：经气管内给予ＬｉｐＰＧＥ１对油酸引起的大鼠急性肺损伤有良好的保护作用，其机制可能与抑制肺内中性粒细胞的聚集与抗氧自由基所造成的损伤有关。

前列腺素E_1、川芎嗪合用对大鼠心肌缺血再灌注损伤的保护作用

目的观察前列腺素Ｅ１（３１２５μｇ·ｋｇ－１）与川芎嗪（２５ｍｇ·ｋｇ－１）合用对大鼠心肌缺血再灌注损伤的影响。方法麻醉大鼠冠脉结扎３０ｍｉｎ后，再灌６０ｍｉｎ诱发心律失常，硫代巴比妥酸法和分光光度法分别测定ＭＤＡ、ＳＯＤ及ＧＳＨＰｘ，原子吸收光度法测定心肌细胞内Ｃａ２＋含量。结果两药小剂量合用的效果优于各药较大剂量单用。联合用药不仅更显著提高缺血再灌心肌ＳＯＤ、ＧＳＨＰｘ活力（Ｐ＜００１），尚可显著降低ＭＤＡ、Ｃａ２＋及血清ＣＫＭＢ含量（Ｐ＜００１），防止缺血再灌室性心律失常的发生（Ｐ＜００１）。结论前列腺素Ｅ１与川芎嗪合用对心肌缺血再灌注损伤的保护作用有显著的协同作用。其作用与提高自由基清除酶活性、抑制脂质过氧化反应和防止心肌细胞内“钙超负荷”

前列腺素E_1抗肝纤维化的临床疗效观察

目的 观察前列腺素E1对活动性肝炎肝硬化的抗纤维化疗效。方法 将 10 0例患者随机分为两组 ,治疗组 5 0例以PGE16 0 μg加入 10 %葡萄糖 2 5 0ml中静滴 ,1次 /d ,疗程 30d。对照组以门冬氨酸钾镁 30ml加入 10 %葡萄糖中 2 5 0ml静滴 ,1次 /d ,疗程相同。两组患者性别、年龄和肝功能均有可比性。治疗前后以放射免疫法检测血清HA、IVC、LN ,B超探测脾脏厚度。结果 治疗组血清HA、IVC以及LN水平明显降低 ,与治疗前及对照组相比较差异有非常显著性 (P<0 .0 1) ,治疗组 5 0 %病例脾脏缩小。结论 PGE1能明显降低肝炎肝硬化患者血清HA、IVC、LN水平 ,且脾脏缩小 ,有一定抗纤维化作用。