阻塞性黄疸病人抗内毒素治疗对一氧化氮的影响

目的 观察阻塞性黄疸患者术前采用抗内毒素治疗对内毒素血症抑制及一氧化氮（NO）水平的影响。方法 随机选择阻塞性黄疸病人分3组在术前分别给予一般治疗（OJ组）,口服胆盐（OJT1组）和静脉注射抗类脂A单克隆抗体（OJT2组）,观察血浆内毒素（ET）及NO含量变化。结果 3组术前ET和NO水平无明显差异。OJT1组和OJT2组用药后血浆ET水平均有明显降低。与OJ组比较（P＜0．01）,术后进一步降低。OJT1组和OJT2组NO在术后3d天与术前比较显著降低。结论 术前应用胆盐及抗内毒素抗体可有效降低阻塞性黄疸病人围手术期血浆ET及NO水平。

Changes of plasma nitric oxide during anti-endotoxin treatment in patients with obstructive jaundice

Objective To investigate the changes of plasma nitric oxide (NO) and the inhibitory effects of preoperative administration of bile salts or anti-endotoxin (ET) antibody against endotoxemia in cases of obstructive jaundice (OJ). Methods The patients with OJ were randomly divided into OJT1 group which taking bile salt orally, OJT2 group which receiving intravenous anti-endotoxin antibody and OJ group which given general treatment. The plasma levels of ET and NO were determined in all the cases. Results The plasma ET level was significantly lower in the patients of OJT1 and OJT2 groups than in OJ group preoperatively and was further decreased postoperatively ( P <0.01). The plasma NO levels were significantly decreased in OJT1 and OJT2 groups 3 d after operation than in preoperation ( P <0.05, 0.01). Conclusion Preoperative administration of oral bile salts and intravenous anti-ET antibody can efficiently decrease the plasma levels of ET and NO pre- and postoperatively in cases of obstructive jaundice.