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1.
目的探讨实脾饮联合四君子汤治疗乙型肝炎肝硬化腹水的临床疗效。方法选择2018年1月至2019年6月期间在我院接受治疗的92例乙型肝炎肝硬化腹水患者作为研究对象,使用随机分组法将其分为对照组与研究组,每组各46例。对照组患者采取抗病毒、保肝、利尿等常规治疗,研究组患者在此基础上采取实脾饮联合四君子汤治疗。分析两组患者治疗前后症状积分、体重、腹围、24h尿量以及ALB、TBiL、AST、ALT水平改善情况。结果治疗前两组患者症状积分、体重、腹围、24h尿量比较,差异无统计学意义(P0.05);治疗后研究组患者症状积分、体重、腹围、24h尿量改善情况明显优于对照组,差异具有统计学意义(P0.05)。治疗前两组患者ALB、TBiL、AST、ALT水平比较,差异无统计学意义(P0.05);治疗后研究组患者ALB、TBiL、AST、ALT水平改善情况明显优于对照组,差异具有统计学意义(P0.05)。结论实脾饮联合四君子汤治疗乙型肝炎肝硬化腹水患者疗效显著,能有效改善患者的临床症状,降低ALB、TBiL、AST、ALT等水平。  相似文献   

2.
苦参素和甘利欣对慢性乙型肝炎患者肝纤维化指标的影响   总被引:2,自引:1,他引:1  
目的:探讨苦参素联合甘利欣治疗慢性乙型肝炎的疗效,及对肝纤维化指标的影响。方法:选择我院200-01/2009-01收治的80例慢性乙型肝炎合并肝纤维化患者作为研究对象,随机分成治疗组和对照组各40例,治疗组给予甘利欣加苦参素,对照组应用复方丹参治疗,3个月为一个疗程。观察比较两组的临床疗效及肝功能指标与肝纤维化指标的改变。结果:治疗组40例的总有效率90.0%;对照组40例的总有效率为57.5%,两组总有效率比较,差异有统计学意义(P0.05)。治疗前两组的肝纤维化指标HA、LN、PCⅢ、Ⅳ-C比较,差异无显著性,治疗3个月后,肝纤维化指标HA、LN、PCⅢ、Ⅳ-C均较治疗前明显下降,且治疗组与对照组比较,差异有统计学意义(P0.05)。治疗前两组的肝功能指标ALT、AST、TBIL、ALB比较,差异无显著性,治疗3个月后,肝功能指标ALT、AST、TBIL、ALB比较均较治疗前明显下降,但治疗组与对照组比较,差异无显著性(P0.05)。结论:苦参素和甘利欣对慢性乙型肝炎患者肝纤维化具有协同作用,阻止或改善肝纤维化有疗效明显,无明显副作用,值得临床推广和应用。  相似文献   

3.
目的:研究以肝切除术后肝功能衰竭(Post-hepatectomy liver failure,PHLF)分级为基准的针对性管理在肝癌患者肝切除术术后康复中的应用及其对肝功能及营养水平的影响.方法:选取本院 2020 年 3 月至2022 年 3 月期间 90 例行肝切除的肝癌患者,随机分为对照组和观察组,对照组 45 例术后实施常规干预措施,观察组45 例术后联合以PHLF分级为基准的针对性管理.对比两组患者肠鸣音恢复和首次肛门排气排便时间,干预前和干预 1 m 后血清白蛋白(Albumin,ALB)、总蛋白(Total protein,TP)、谷丙转氨酶(Alanine Aminotransferase,ALT)、总胆红素(Total Bilirubin,TBIL)、谷草转氨酶(Aspartate Aminotransferase,AST)水平,干预1 m内并发症发生情况,患者PHLF平均诊断时限.结果:观察组肠鸣音恢复时间、排气时间、排便时间均短于对照组(P<0.05);干预后,两组ALB、TP水平均升高(P<0.05),其中观察组升高幅度更大(P<0.05);干预后,对照组ALT、TBIL、AST均升高(P<0.05),观察组AST降低(P<0.05),观察组ALT、TBIL、AST低于对照组(P<0.05);两组并发症发生率差异无统计学意义;观察组PHLF平均诊断时限短于对照组(P<0.05).结论:以PHLF分级为基准的针对性管理对肝癌肝切除术患者效果显著,能够有效促进患者术后胃肠功能恢复,改善营养状况和肝功能.  相似文献   

4.
目的 探讨人工肝血浆置换(PE)联合分子吸附系统(MARS)对重症肝炎肝硬化患者血清内毒素、细胞因子清除和肝功能的影响.方法 将我院105例重症肝炎肝硬化患者随机分为实验组(53例)和对照组(52例),实验组接受人工肝PE+ MARS治疗,对照组接受MARS治疗,两组均治疗6个月,比较两组治疗前后血清内毒素、细胞因子清除和肝功能等情况.结果 治疗6个月后,两组血清内毒素、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、凝血酶原时间(PT)均显著降低(P<0.05),凝血酶原活动度(PTA)、纤维蛋白原(FIB)及白陶土部分凝血酶时间(KPTT)均明显上升(P<0.05),实验组肝功能、凝血功能、内毒素和细胞因子水平改善幅度均大于对照组(P<0.05);实验组患者治疗1、3、6个月后临床症状改善情况均明显优于对照组(P<0.05);实验组存活率显著高于对照组(98.11%与86.54%,P<0.05);实验组发热发生率明显高于对照组(P<0.05),但皮疹、水肿、口唇麻木发生率与对照组比较差异无统计学意义(P>0.05).结论 PE联合MARS能显著改善重症肝炎肝硬化患者临床症状和肝功能,降低内毒素水平,清除细胞因子,最终提高患者存活率.  相似文献   

5.
目的 探讨阿德福韦酯联合拉米夫定治疗慢性乙型病毒性肝炎患者的疗效.方法 选择符合标准的患者80例,随机分为观察组和对照组各40例,对照组应用拉米夫定,观察组应用阿德福韦酯联合拉米夫定,比较治疗效果.结果 治疗6个月后,两组患者血清AST及ALT水平较治疗前均下降(P<0.05),但治疗后两组的AST水平和ALT水平的差异无统计学意义(P>0.05).治疗后,观察组患者外周血中HBV DNA含量低于对照组(P<0.05).治疗后,观察组患者外周血CD4+T细胞计数高于对照组(P<0.05)、CD8+T细胞计数低于对照组(P<0.05).结论 阿德福韦酯联合拉米夫定治疗慢性乙型病毒性肝炎的效果优于单独应用拉米夫定.  相似文献   

6.
目的:分析苦参素联合恩替卡韦治疗失代偿期乙型肝炎肝硬化的临床疗效。方法选择我院2012年2月~2014年2月收治的64例失代偿期乙型肝炎肝硬化患者为研究对象,随机数字法将其分为两组,对照组患者给予苦参素治疗,实验组患者行苦参素联合恩替卡韦治疗,对两组患者治疗前后肝功能指标及HBV-DNA变化进行比较。结果实验组患者治疗后ALB、AST、ALT、TBIL及HBV-DNA明显优于治疗前、对照组,差异有统计学意义,<0.05。结论苦参素联合恩替卡韦治疗能明显改善患者肝功能,抑制HBV-DNA复制,值得在失代偿期乙型肝炎肝硬化治疗中进一步应用。  相似文献   

7.
目的 检测慢性重型乙型肝炎患者血清中IL-23表达,探讨IL-23水平与丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBil)及HBV DNA载量的相关性.方法 用酶联免疫吸附法(ELISA)检测50例慢性重型乙型肝炎患者(重肝组)及18名健康人(对照组)血清中IL-23表达,并与患者ALT、AST、TBil、HBV DNA载量进行相关性分析.结果 重肝组患者血清中IL-23表达高于对照组,两组之间的差异有统计学意义(P<0.05);IL-23水平与ALT、AST呈正相关(P<0.05),与TBil、HBV DNA载量无相关性(P>0.05).结论 慢性重型乙型肝炎患者血清中IL-23表达增高,与炎症程度相关,可能参与慢性重型乙型肝炎的发病.  相似文献   

8.
目的研究异甘草酸镁治疗慢性乙型肝炎疗效及有效性。方法选择本院2017年4月~2019年6月诊治的102例慢性乙型肝炎患者作为研究对象,运用随机数表法将其分为观察组与对照组,每组各51例。对照组采用甘草酸二铵治疗,观察组采用异甘草酸镁治疗。比较两组患者疗效、症状改善情况和肝功能。结果治疗前两组患者ALT、AST、TBil比较,差异无统计学意义(P0.05);治疗4周后观察组患者ALT、AST、TBil显著低于对照组(P0.05);观察组患者临床有效率为96.08%,显著高于对照组78.43%(P0.05);观察组患者乏力、消化道症状、肝区不适例数显著低于对照组(P0.05)。结论异甘草酸镁治疗慢性乙型肝炎疗效显著,明显改善患者肝功能,值得应用推广。  相似文献   

9.
目的 探讨恩替卡韦联合舒肝宁注射液对慢性乙型肝炎患者临床研究.方法 138例慢性乙肝肝炎患者,随机分成两组,各69例.对照组:单纯口服恩替卡韦治疗.观察组:恩替卡韦联合舒肝宁注射液治疗.比较两组患者的疗效、肝功能、外周血树突状细胞MHC-DR、CDla、CD83、CD86水平及淋巴细胞亚群CD4+、CD8+、CD4 +/CD8+水平的变化.结果 观察组总有效率89.9%高于对照组总有效率72.5%,差异具有统计学意义(P<0.01).治疗后,观察组患者TBIL(15.6 ± 3.3) umol/l、AST(18.3 ±4.4)U/l、ALT(20.5 ±4.0)U/l都低于对照组患者TBIL(30.8 ±6.8)umol/l、AST(33.6±6.6)U/l、ALT(35.5 ±6.9)U/l,差异均有统计学意义(P<0.01).治疗后,观察组患者的外周血树突状细胞MHC-DR、CDla、CD83、CD86水平都高于对照组,差异均有统计学意义(P<0.01).治疗后,观察组患者的CD4+、CD4 +/CD8+水平都高于对照组,差异均有统计学意义(P<0.01).治疗后,观察组CD8+水平低于对照组,差异具有统计学意义(P<0.01).结论 恩替卡韦联合舒肝宁注射液治疗慢性乙型肝炎疗效确切,可以改善患者的肝功能,并通过调节外周血树突状细胞和淋巴细胞亚群功能从而起到抗病毒的作用.  相似文献   

10.
目的:探讨苦黄注射液辅助治疗黄疸型病毒肝炎的临床效果及对患者肝功能的影响作用。方法:选取本院收治的124例黄疸型病毒肝炎患者随机分为研究组和对照组各62例,两组患者均采用常规护肝等治疗措施,研究组加用苦黄注射液进行辅助治疗,对比两组的临床疗效。结果:治疗后研究组和对照组的血清总胆红素(TBIL)、直接胆红素(DBIL)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)较本组治疗前均显著降低(P<0.05),治疗后研究组患者的TBIL、DBIL、ALT、AST水平显著低于对照组患者(P<0.05)。治疗后研究组和对照组的巩膜黄染、身黄、尿黄、纳差、肝区叩痛、倦怠乏力积分较本组治疗前均显著降低(P<0.05),治疗后研究组患者的巩膜黄染、身黄、尿黄、纳差、肝区叩痛、倦怠乏力积分显著的低于对照组患者(P<0.05)。治疗后研究组的愈显率88.71%显著高于对照组的72.58%(P<0.05)。结论:苦黄注射液辅助治疗黄疸型病毒肝炎具有显著的临床效果,患者的肝功能恢复效果更好。  相似文献   

11.
蛋白质组学是继基因组学之后出现的一门新兴学科,但近年来发展十分迅速,在研究方法上日见成熟,研究领域也日趋广泛。本文主要介绍了近年来蛋白质组学的常用技术及蛋白质组学在肝脏病研究中的若干进展。  相似文献   

12.
Remarkable advances have been made recently in the area of liver regeneration. Even though liver regeneration after liver resection has been widely researched, new clinical applications have provided a better understanding of the process. Hepatic damage induces a process of regeneration that rarely occurs in normal undamaged liver. Many studies have concentrated on the mechanism of hepatocyte regeneration following liver damage. High mortality is usual in patients with terminal liver failure. Patients die when the regenerative process is unable to balance loss due to liver damage. During disease progression, cellular adaptations take place and the organ microenvironment changes. Portal vein embolization and the associating liver partition and portal vein ligation for staged hepatectomy are relatively recent techniques exploiting the remarkable progress in understanding liver regeneration. Living donor liver transplantation is one of the most significant clinical outcomes of research on liver regeneration. Another major clinical field involving liver regeneration is cell therapy using adult stem cells. The aim of this article is to provide an outline of the clinical approaches being undertaken to examine regeneration in liver diseases.  相似文献   

13.
嗜酒者肝脏病变的形态学研究   总被引:11,自引:1,他引:11  
研究了临床确定的40例嗜酒者肝穿标本的形态变化,普通嗜洒考与重度嗜酒者各20例,基本病变为:(1)肝细胞变性,包括大泡状肝细胞脂变,灶状肝细胞变小,灶状气球样变等;(2)肝细胞坏死灶形成伴中性粒细胞浸润,肝细胞内巨大线粒体或麦氏小体;(3)窦周纤维化,肝纤维化及细结节性肝硬变等。据此,我们将酒精性肝病分为五个病理类型。研究结果证明,肝脏的病变程度和饮酒量密切相关,饮酒时间超过10年后,肝坏死灶及肝  相似文献   

14.
肝癌患者肝动脉的变异   总被引:1,自引:0,他引:1  
对己确诊为肝癌的327位患者做的486人次肝动脉插管介入治疗过程中,发现肝癌患者肝动脉的变异很大。327位肝癌患者首次肝动脉造影,肝动脉有变异的35例,变异率为10.7%。经过1~3次肝动脉化疗栓塞后肝动脉造影159人次,共115例,肝动脉有变异的37例,肝动脉变异率为32.1%,变异的肝动脉主要是由肠系膜上动脉、右膈下动脉或直接由腹主动脉和脾动脉发出。本文详细叙述了肝癌患者变异肝动脉的起始方位,以便对我们在今后肝癌导管治疗中有所帮助。  相似文献   

15.
Summary Fasting plasma caffeine concentration and various parameters of caffeine elimination from plasma obtained after a standardized oral dose of 140 mg caffeine have been compared in nine patients with liver cirrhosis, eight patients with non-cirrhotic liver disease and ten healthy volunteers with regard to their ability to discriminate between the different groups. Fasting plasma caffeine concentrations were significantly higher in cirrhotics (11.1±10.5 mol/l) than in healthy volunteers (1.5±0.8 mol/l). The respective values measured in patients with non-cirrhotic liver disease (3.1±3.1 mol/l) did not differ significantly from the controls. Plasma disappearance rate and clearance of caffeine were significantly decreased in cirrhotics (0.11±0.02 h–1; 1.0±0.3 ml/min per kg) and in patients with non-cirrhotic liver disease (0.18±0.04 h–1; 2.2±0.7 ml/min per kg) as compared to healthy volunteers (0.23±0.04 h–1; 3.1±0.9 ml/min per kg). Plasma caffeine concentration determined 12 h after administration of the test dosage discriminated best between patients with cirrhosis (5.4±1.6 mol/l), patients with noncirrhotic liver disease (2.0±1.4 mol/l) and healthy volunteers (0.8±0.2 mol/l). These results, the safety of the test compound and the simplicity of a single caffeine determination in plasma 12 h after a standardized dose of caffeine make this test attractive for evaluation of liver function.  相似文献   

16.
Since laparoscopic liver resection was first introduced in 2001, Korean surgeons have chosen a laparoscopic procedure as one of the treatment options for benign or malignant liver disease. We distributed and analyzed a nationwide questionnaire to members of the Korean Laparoscopic Liver Surgery Study Group (KLLSG) in order to evaluate the current status of laparoscopic liver resection in Korea. Questionnaires were sent to 24 centers of KLLSG. The questionnaire consisted of operative procedure, histological diagnosis of liver lesions, indications for resection, causes of conversion to open surgery, and postoperative outcomes. A laparoscopic liver resection was performed in 416 patients from 2001 to 2008. Of 416 patients, 59.6% had malignant tumors, and 40.4% had benign diseases. A total laparoscopic approach was performed in 88.7%. Anatomical laparoscopic liver resection was more commonly performed than non-anatomical resection (59.9% vs 40.1%). The anatomical laparoscopic liver resection procedures consisted of a left lateral sectionectomy (29.3%), left hemihepatectomy (19.2%), right hemihepatectomy (6%), right posterior sectionectomy (4.3%), central bisectionectomy (0.5%), and caudate lobectomy (0.5%). Laparoscopy-related serious complications occurred in 12 (2.8%) patients. The present study findings provide data in terms of indication, type and method of liver resection, and current status of laparoscopic liver resection in Korea.  相似文献   

17.
BackgroundIt is uncertain whether non-alcoholic fatty liver disease (NAFLD) is associated with subclinical hypothyroidism (SH) in pediatric patients. The purpose of this study was to investigated the prevalence and related factors of SH in pediatric patients with NAFLD. We also evaluate the association between liver fibrosis and SH.MethodsWe retrospectively reviewed medical records for patients aged 4 to 18 years who were diagnosed with NAFLD and tested for thyroid function from January 2015 to December 2019 at 10 hospitals in Korea.ResultsThe study included 428 patients with NAFLD. The prevalence of SH in pediatric NAFLD patients was 13.6%. In multivariate logistic regression, higher levels of steatosis on ultrasound and higher aspartate aminotransferase to platelet count ratio index (APRI) score were associated with increased risk of SH. Using receiver operating characteristic curves, the optimal cutoff value of the APRI score for predicting SH was 0.6012 (area under the curve, 0.67; P < 0.001; sensitivity 72.4%, specificity 61.9%, positive predictive value 23%, and negative predictive value 93.5%).ConclusionSH was often observed in patients with NAFLD, more frequently in patients with more severe liver damage. Thyroid function tests should be performed on pediatric NAFLD patients, especially those with higher grades of liver steatosis and fibrosis.  相似文献   

18.
Summary We report the case of a 44-year-old man who was transplanted in 1986 for hepatocellular carcinoma in a HBsAG-positive liver cirrhosis. The patient had no severe complications postoperatively. He received passive immunization for the prevention of hepatitis B reinfection during the first 6 months after liver grafting. Twelve months after the transplantation the new liver was reinfected with hepatitis B virus. Without any clinical or laboratory signs of severe hepatitis, the patient developed a histologically proven complete liver cirrhosis within 8 months after reinfection of the graft. The reasons for this might have been, first, a deleterious course of the infection under immunosuppressive therapy, and, second, the additional influence of a postoperatively acquired CMV infection or the combined toxic influence of cyclosporin A and its metabolites on the acute inflammation in the liver.Abbreviations ALT Alanine aminotransferase (EC No 2.6.1.2) - AST Aspartate aminotransferase (EC No 2.6.1.1) - CMV Cytomegalo virus - EBV Ebstein-Barr virus - ELISA Enzyme linked immunosorbentassay - HBV Hepatitis B virus - HLA Human leukocyte antigen - HSV Herpes simplex virus  相似文献   

19.
Although laparoscopic surgery has become more popular, its technical difficulties have limited the applications of this technique to liver surgery. We report here on our experience with liver resection with using the laparoscopy-assisted (Lap-Assist) and total laparoscopic (Total-Lap) methods. From April 2001 to June 2003, a total of 20 laparoscopic anatomical resections of the liver were retrospectively reviewed. These were comprised of 10 cases in which the Lap-Assist method was used (these were performed during the early study period), and 10 cases in which the Total-Lap was used (these were done in the later study period). In the Lap-Assist group, the following resections were performed: 7 cases of left lateral sectionectomy, a case of left hemihepatectomy, a case of right hemihepatectomy and a case of open conversion. In the Total-Lap group, 6 cases of left hemihepatectomy and 4 cases of left lateral sectionectomy were performed. The sizes of the incisions were 8.7 cm and 4.6 cm, respectively, (p=0.000). There were no differences in the operation times, the transfusion amounts, the starting days of the patients' diets, the complication rates or the durations of the hospital stay between the two groups. Both the laparoscopy-assisted method and the total laparoscopic method are feasible to use for performing anatomical liver resection.  相似文献   

20.
Summary Intraacinar regionality in glycogen withdrawal during fasting was studied in the liver of the mouse. When animals were fasted from 10.00 a.m. onwards, glycogen withdrawal began in zone 1, spreading gradually to zone 3, and after 12 h glycogen disappeared throughout the acinus. After 24 h new glycogen accumulated in various portions of the acinus. However, when animals were fasted from 10.00 p.m. or 12 midnight to the following morning, glycogen was withdrawn evenly throughout the lobule. After 24 h glycogen disappeared throughout the acinus. These results show that there is a heterogeneity in the hepatocyte with respect to glycogen withdrawal during fasting by day but not by night. Therefore, the discrepancy in reported results on the intraacinar distribution of glycogen during fasting is probably due to the time of sacrificing animals.  相似文献   

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