乌司他丁对门脉高压症出血患者免疫功能和肝脏的保护作用

目的：探讨乌司他丁（UTI）对门脉高压症出血患者免疫功能和肝脏的保护作用。方法：将20例门脉高压症出血患者随机分为两组,Ⅰ组（n=10）为一般治疗组,Ⅱ组（n=10）为UTI治疗组,Ⅰ、Ⅱ组出血后1、3、7d分别抽取静脉血,检测T细胞亚群（CD4、CD8、CD4/CD8）、血清TNF-α、IL-6浓度,并检测1、3、7d的肝功能。另选肝硬化门脉高压症未出血患者（n=10）作为对照组（Ⅲ组）。结果：①Ⅰ、Ⅱ治疗组CD4和CD4/CD8第1天下降明显,第3、7天时,Ⅱ组高于Ⅰ组并逐渐恢复至对照组水平;Ⅰ、Ⅱ组出血后第1天血IL-6、TNF-α浓度较对照组显著升高,随后逐步下降。Ⅱ组IL-6、TNF-α下降较Ⅰ组快,差异有统计学意义。②出血后7d内,Ⅰ、Ⅱ组总胆红素（TBil）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）均先升高后下降（P〈0.05）,但出血后第7天Ⅱ组较Ⅰ组下降快。结论：肝硬化门脉高压症大出血后应用UTI治疗,可改善患者免疫功能低下,缓解急性炎性反应,起到保护肝脏功能的作用。

Protective effects of ulinastatin on liver function and immune function of portal hypertension with hemorrhage

Objective：To investigate the protective effects of ulinastatin on the liver function and immune function of portal hypertension with hemorrhage.Methods：A total of 20 portal hypertension patients were randomly divided into two groups.The patients in group Ⅰ（n=10）received general therapy and those in group Ⅱ（n=10）received the general therapy and UTI after hemorrhage.The concentration of CD4,CD8,CD4/CD8,TNF-α,IL-6 and liver function was measured on the 1st,3rd,7th day.Results：On the 7th day after hemorrhage,the levels of TBil,ALT and AST were elevated firstly and then decreased in groups Ⅰ and Ⅱ.The decrease of TBil,ALT and AST levels were significantly faster in group Ⅱ than group Ⅰ（P0.05）.On the 3rd,7th day after hemorhage The levels of concentration of CD4,CD8 was faster in group Ⅱ than in group Ⅰ.Conclusion：Ulinastatin can effectively protect liver and immune function of portal hypertension with hemorrhage.