超长效氨氯地平皮下埋植制剂对自发性高血压大鼠肝、肾功能的影响

[目的]探讨超长效氨氯地平皮下埋植制剂对自发性高血压大鼠(SHR)肝、肾功能的影响.[方法]将有机高分子聚合物聚己内酯合成缓释载体,加入氨氯地平原料药制成可皮下埋植的氨氯地平缓释制剂.将SHR随机分成模型对照组(MC组)、空白载体埋植组(BCE组)、氨氯地平溶液灌胃组(ASG组)、氨氯地平缓释制剂埋植组(ARI组),每...     

右美托咪定对脊柱手术患者围术期血流动力学及肝肾功能的影响

目的探讨右美托咪定对脊柱手术患者围术期血流动力学及肝肾功能的影响。方法选取2016年1月～2018年12月于我院拟择期行脊柱手术患者150例,采取计算机随机数字法分为观察组和对照组各75例。两组患者均行气管插管全麻,麻醉诱导前,观察组患者注射右美托咪定,术中持续泵注至手术结束前20min,对照组患者泵注等量生理盐水。记录麻醉诱导前15min(T0)、麻醉诱导后5min(T1)、手术开始后45min(T2)、气管拔出时(T3)患者HR、MAP值,于麻醉诱导前30min(t0)、手术结束时(t1)、术后2d(t2)测定患者血清谷草转氨酶(AST)、谷丙转氨酶(ALT)、尿素(UREA)、肌酐(Cr)、胱抑素(CysC)水平,比较两组患者术中瑞芬太尼、丙泊酚、顺式阿曲库铵用量、尿量及低血压发生率。结果观察组患者T1时HR较T0时降低,且低于对照组,MAP较T0时升高,且高于对照组,差异均有统计学意义(P<0.05);对照组患者T2、T3时HR、MAP较T0时升高,且高于观察组,差异均有统计学意义(P<0.05);观察组患者t1、t2时血清AST、ALT、UREA及t1时Cr水平较t0时低,且均低于对照组,差异均有统计学意义(P<0.05);观察组患者术中瑞芬太尼、丙泊酚用量较对照组少,尿量较对照组多,差异均有统计学意义(P<0.05);两组顺式阿曲库铵用量、术中低血压发生率比较差异无统计学意义(P>0.05)。结论脊柱手术患者围术期使用右美托咪定可维持血流动力学稳定,减少麻醉药物用量,有利于保护肝肾功能。     

犬肝动脉热灌注对肝、肾功能的影响

目的 研究热灌注液经肝动脉灌注对犬肝组织学及肝、肾功的影响。方法 经犬肝动脉灌注入60℃生理盐水180ml,持续30min。比较热灌注前后肝脏组织及肝、肾功的变化。结果 ①谷丙转氨酸、谷草转氨酶于灌注后24h开始升高,72h达高峰（P＜0.01）,216h后恢复正常;总胆红素、白蛋白、γ－谷氨酰基转换酶无明显变化(P＞0.05）;②肝组织可见一过性损伤,168h后正常。③肾功无明显变化（P＞0.05）。结论 介入性热疗对犬肝组织及肝、肾功能有一过性影响。     

外用红油膏对大鼠体内汞蓄积及肝肾功能的影响

目的:研究不同剂量的红油膏外用30 d对大鼠体内汞蓄积及肝肾功能的影响.方法:将40只大鼠随机分成正常组与红油膏低、中、高剂量组,每组10只.各组大鼠背部造成面积为3 cm×3 cm的全层皮肤缺损创面,除正常组外,红油膏低、中、高剂量组分别予以4.744 mg、94.875 mg、189.750 mg红油膏纱条外敷.持...     

双环醇对肝硬化模型大鼠炎性因子、胃肠功能及肝功能的影响

[目的] 探讨双环醇对肝硬化模型大鼠炎性因子、胃肠功能及肝功能的影响.[方法] 选择雄性SD大鼠60只并分为对照组、模型组以及双环醇低剂量组、中剂量组、高剂量组,采用四氯化碳皮下注射的方式建立肝硬化模型.双环醇低剂量组、中剂量组、高剂量组分别给予0.1 g/kg、0.2 g/kg、0.3 g/kg双环醇灌胃.干预后8周时,检测并比较各组小鼠炎性因子[白细胞介素-1β(IL-1β)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)] 、胃肠黏膜屏障功能指标[降钙素原(PCT)、D-乳酸、内毒素(LPS)] 、肝功能指标[丙氨酸氨基转氨酶(ALT)、天冬氨酸氨基转移酶(AST)] 的变化.[结果] 干预后8周时,模型组大鼠血清中IL-1β、IL-8、TNF-α、ALT、AST、PCT、LPS、D-乳酸水平均显著高于对照组(P<0.05);双环醇低剂量组、中剂量组、高剂量组大鼠血清中IL-1β、IL-8、TNF-α、ALT、AST、PCT、LPS、D-乳酸水平均低于模型组(P<0.05);双环醇剂量越大,血清中IL-1β、IL-8、TNF-α、ALT、AST、PCT、LPS、D-乳酸的水平越低(P<0.05).[结论] 双环醇对肝硬化模型大鼠的胃肠功能及肝功能具有保护作用,同时能够抑制炎性因子的合成,是治疗肝硬化的理想药物.     

Use of Liver Function Tests as Predictors of Rifampicin Metabolism in Cirrhosis

Normal subjects taking rifampicin regularly, show a fall inserum and urinary drug concentrations from enzyme inductionand increased biliary excretion. In cirrhosis, hepatocellulardysfunction and impaired biliary excretion may prevent thesechanges, but there is little information on how the drug shouldbe prescribed in such patients. Serum and urinary rifampicinconcentrations were therefore measured in thirteen patientsand five controls during a seven-day course (600 mg/day). In controls, peak serum concentrations on Day 7 were lower thanon Day 1 (7·0 ± 3·0 and 8·0 ±1·0 µg/ml respectively) and this was also the casefor nine cirrhotic patients with mild impairment of liver function(6·0 ± 1·0 and 11·0 ± 2·0µg/ml (p < 0·02). In both groups there was anaccompanying fall in urinary rifampicin excretion due to a decreasein desacetylrifampicin excretion. In the remaining four cirrhoticpatients, peak serum rifampicin levels rose from 11·0± 5·0 to 17·0 ± 6·0 µg/mland urinary excretion of desacetylrifampicin did not fall. Althoughvalues for serum albumin and prothrombin time were of limitedvalue in predicting drug accumulation, pretreatment levels ofbilirubin exceeding 50 µmolg/ml were present in all fourpatients showing an increase in serum rifampicin concentration.Furthermore, only in this group was there a rise in serum bilirubinduring treatment, almost certainly the result of competitionbetween rifampicin and bilirubin for hepatic uptake and excretion.In patients with cirrhosis, bilirubin concentrations exceeding50 µmol/l should be an indication for reduction in rifampicindosage.     

视黄醇结合蛋白4检测在营养性疾病及肝肾损害检测中的临床应用

视黄醇结合蛋白（retinol binding protein,RBP）是一种分泌型视黄醇结合蛋白,主要合成于肝脏,广泛分布于人体血液、尿液等体液中的视黄醇（VitA）运载蛋白,在协助 VitA发挥生理功能中起到关键作用[1]。最新研究表明：RBP4是一种新的脂肪细胞因子,参与胰岛素抵抗和2型糖尿病的发生,与糖尿病肾病、营养性疾病等的发展存在着一定的相关性。这一发现使得 RBP4更加受到人们的重视。该文就 RBP4的生理功能,在肝肾疾病、糖尿病等各类疾病方面的应用以及新型临床检测方法作一综述。     

Liver Function Test Abnormalities in Users of Aqueous Kava Extracts

Abstract

Introduction.?Hepatic toxicity from manufactured herbal remedies that contain kava lactones has been reported in Europe, North America, and Australia. There is no evidence for serious liver damage in kava‐using populations in Pacific Island societies or in Indigenous Australians who have used aqueous kava extracts. This article presents evidence that liver function changes in users of aqueous kava extracts appear to be reversible. Data from one Arnhem Land community [Northern Territory (NT), Australia] with 340 indigenous people older than 15 years of age in 2000 are used. Methods.?This study was a cross‐sectional study with 98 participants, 36 of whom had never used kava. Among 62 kava users, 23 had discontinued kava at least 1 year before the study. Continuing users had not used kava for 1 to 2 months (n = 10) or 1 to 2 weeks previously (n = 15). Some (n = 14) had used kava within the previous 24 hr. Liver function tests were compared across these groups, taking into account differences due to age, sex, alcohol, and other substance use. Results.?The average quantity of kava powder consumed was 118 g/week, and median duration of use was 12 years (range, 1–18 years). Kava usage levels were less than one‐half of those found in previous studies. More recent kava use was independently associated with higher levels of liver enzymes gamma‐glutamyl transferase (GGT) (p < 0.001) and alkaline phosphatase (ALP) (p < 0.001), but not with alanine aminotransferase or bilirubin, which were not elevated. In those who were not heavy alcohol users, only those who used kava within the previous 24 hr showed GGT levels higher than nonusers (p < 0.001), whereas higher ALP levels occurred only in those who last used kava 1 to 2 weeks (p = 0.015) and 24 hr previously (p = 0.005). Discussion.?Liver function changes in users of aqueous kava extracts at these moderate levels of consumption appear to be reversible and begin to return to baseline after 1 to 2 weeks abstinence from kava. No evidence for irreversible liver damage has been found.     

尿NAG、RBP的变化在肾功能正常的肾病患者中的应用

目的:探讨肾功能正常的肾小球和肾血管疾病患者尿NAG、RBP的变化，以确定在上述患者中尿NAG和RBP的应用价值。方法:选择肾功能正常的慢性肾小球肾炎患者(CGN)20例、原发性肾病综合征(NS)未缓解期患者18例、高血压肾损害患者(HN)10例、糖尿病性肾病患者(DN)20例，分别进行尿NAG／尿肌酐、RBP检测，并与12例正常人对照。结果:与正常组相比，各肾脏病组尿NAG／尿肌酐、RBP均有不同程度升高，以NS组最明显。结论:肾小球和肾血管疾病在出现肾功能减退之前，即可能存在一定程度的肾小管一间质损伤，从而在尿NAG和RBP的变化中反映出来。     

影响肝功能检验结果的临床分析与研究

目的探讨标本发生溶血现象对肝功能分析的干扰和影响。方法随机抽取本院2011年1月～2012年6月门诊患者112例空腹静脉血液,制备正常血清和溶血血清,用生化分析仪检测并比较两组标本肝功能检查结果有无明显差异。结果溶血前后血液样本中TBIL、DBIL、TP、ALB、ALT和AST均显著或极显著增高(P<0.05或P<0.01),GGT、ALP均极显著降低(P<0.01)。结论溶血对多项肝功能检验的准确性有明显的影响,临床应加以避免。     

Effect of Nicotinamide on Carbohydrate Metabolism in the Rat Liver during Starvation

Abstract. A single high dose of nicotinamide (500 mg/kg body weight) results in an eight-hour long inhibition of lipolysis in adipose tissue by transformation to nicotinic acid. In the present paper the effect of inhibited lipolysis on carbohydrate and amino acid metabolism after forty-eight hours starvation was examined in vivo. Within two hours after the injection of nicotinamide (Nam) the plasma level of FFA declines from 900 μval/l to 300 μval/l. The FFA level rises again between 8–12 h after Nam injection. The reduced supply of FFA to the liver leads to a reduced oxidation rate, characterized by a fall in the acetyl-CoA content of the liver and of ketone bodies in liver and blood. Simultaneously there is an increase in protein catabolism. This increase is characterized by increased urinary excretion of urea up to 10 h after Nam injection and by a higher urea production rate in liver slices of rats pretreated with Nam. In the liver the levels of the following amino acids rise very sharply SER (100%), CIT (400%), ORN (250%), ALA (300%), α-AB (470%), VAL (350%), LEU (250%), ILE (370%). The content of THR is reduced to 63%, and GLY to 50%. In comparison to the values of the control groups the contents of ASP, GLU, TYR, LYS, HIS and ARG are unchanged. The result of the increased precursor supply for gluconeogenesis is a higher rate of glucose production, characterized by an increase in blood glucose by 40 mg/100 ml, by an increase in liver glycogen content, by an increase in the concentrations of intermediates of the Embden-Meyerhof-pathway (mainly the concentrations of PEP (870%), 3PGA (480%), FDP (150%), G6P (250%) and glucose (220%). In liver slice experiments the glucose production rate from L-ALA rises significantly, compared to the control group, after pretreatment of the animals with Nam. The results show that a stimulation of gluconeogenesis is obtainable in vivo, although the oxidation rate of FFA is reduced. Thus, they support the assumption, that an increased fatty acid oxidation rate is not a primary condition of stimulated gluconeogenesis.     

严重创伤患者高血糖与肝、肾主要器官功能损害的相关性

目的探讨严重创伤患者血糖与肝、肾主要器官功能损害的相关性。方法随机抽查2002年12月至2004年12月本院创伤ICU患者病历1156份,根据住院期间血糖最高水平,分为血糖正常组370例(≤6.1mmol/L)和血糖升高组786例(>6.1mmol/L)。统计不同血糖水平组的尿蛋白、血清尿素氮、血清丙氨酸转氨酶、总胆红素等肝、肾功能指标,分析严重创伤患者血糖水平与肝、肾功能损伤之间的关系。结果(1)血糖升高组丙氨酸转氨酶明显高于血糖正常组(P<0.01)。血糖升高组尿蛋白阳性率明显高于血糖正常组。(2)1156例创伤患者血糖水平与血清尿素氮、丙氨酸转氨酶和总胆红素的相关系数分别为0.456、0.563和0.328,P均<0.05,相关显著。结论严重创伤高血糖反应与创伤后肝、肾功能受损相关。严重创伤患者高血糖可促进肝、肾功能损伤,应引起临床高度重视。     

气腹建立前预处理对腹腔镜手术患者肝功能的影响

[目的]观察气腹前预处理对腹腔镜手术患者肝功能的影响.[方法]拟在全麻下行腹腔镜子宫切除术患者50例,随机分为预处理组和对照组各25例.对照组常规建立CO2气腹;预处理组在建立气腹前实施预处理:5 min充气和5 min放气,反复两次.检测术前、手术结束时及术后d1、d3 血谷丙转氨酶(ALT)、谷草转氨酶(AST)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)浓度.[结果]两组患者手术结束时、术后d1,ALT、AST、TNF-α、IL-6均较术前明显升高(P<0.05),术后d3恢复到术前水平.与对照组比较,手术结束时、术后d1预处理组ALT、AST、TNF-α、IL-6显著降低(P<0.05).[结论]预处理可能通过抑制促炎性细胞因子的释放,对腹腔镜手术患者肝脏功能具有保护作用.     

抗结核药物对糖尿病患者肝功能的影响

糖尿病是常见的代谢内分泌疾病,其合并症常常直接影响患者的预后。糖尿病并发肺结核颇为常见,特别是中老年患者更为明显。由于两者相互关系复杂,合理充分的化疗十分重要。近些年来,国内对抗结核药物不良反应的报道较多,但对糖尿病并发肺结核化疗时肝功能的变化报道较少。为此,现将我们在1999～2001年内科及传染科收治的30例糖尿病并发肺结核的住院患者,在抗结核治疗前后肝功能的变化报告如下。     

缺氧对急性呼吸窘迫综合征患者消化道出血及肝功能的影响

目的探讨缺氧对急性呼吸窘迫综合征(ARDS)患者消化道出血及肝功能影响.方法65例ARDS患者分为呼衰指数＜100mmHg(A组)与呼衰指数100～200mmHg(B组)二组,比较消化道出血发生率、红细胞(RBC)、血红蛋白(HB)、及肝功能的变化.结果ARDS患者可发生消化道出血,其发生率为15.4%,A组消化道出血率高于B组(P＜0.05),且A组RBC、HB低于B组(P＜0.05);非消化道出血ARDS患者中,A组RBC、HB低于B组(P＜0.01);A组患者病前健康状况优于B组(P＜0.05),但消化道出血发生率及RBC、血红蛋白减少程度大于B组(P＜0.05,P＜0.01);A组丙氨酸氨基转移酶(ALT)高于B组而血清总蛋白(TP)、血清白蛋白(Alb)低于B组(P＜0.05).结论①严重缺氧促发了ARDS患者RBC、HB减少及消化道出血的发生;缺氧越严重,RBC、HB减少越明显,消化道出血发生率越高.②严重缺氧促发了ARDS患者ALT增高,TP、Alb降低,并随缺氧加重而加重.     

^13C-美沙西汀呼气试验检测肝功能临床应用进展

二氧化碳（CO2）呼气试验作为一种定量的动态肝功能检测手段已经有近30a的历史。呼气试验在评价慢性肝病时的肝脏功能、进展期肝病的预后以及肝移植的随访等方面具有十分重要的价值。自1983年^13C-美沙西汀呼气试验（^13C-Methacetin breath test，MBT）应用于临床，近年来，已广泛应用于临床肝功能检测,     

酮体比、肝功对犬肝热缺血损伤程度的判断

本实验利用犬游离肝及Y型静脉转流模型,观察肝热缺血损伤的改变。发现肝脏血流阻断后酮体比明显下降,随时间延长而稍加重。犬肝经60分钟热缺血后,恢复血供肝活力尚可,而90分钟组活力较差,酮体比是一个可早期、准确判断肝活力的指标。