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21.
Abstract One hundred eighty-one consecutive patients with fulminant hepatic failure (FHF) presenting in a 2-year period were reviewed. In this cohort we examined the impact of pretransplant renal failure on mortality and morbidity following orthotopic liver transplantation (OLTx). Twenty-seven patients (18 female, 9 male) with a median age of 43.5 years (range 19–65 years) underwent OLTx. FHF was due to idiosyncratic drug reaction ( n = 4), paracetamol overdose ( n = 3), seronegative hepatitis ( n = 17), hepatitis B ( n = 1), veno-occlusive disease ( n = 1), and Wilson's disease ( n = 1). Renal failure was present in 14 patients, 7 of whom died (whereas there was 100 % survival in patients without renal failure). Pretransplant renal failure was associated with prolonged mechanical ventilation (13 days vs 6 days, P = 0.05), prolonged intensive care stay (17 days vs 8 days, P - 0.01) and prolonged hospital stay (27 vs 21 days, P = NS). Pretransplant renal failure did not predict renal dysfunction at 1 year after OLTx. We conclude that the survival of patients transplanted for FHF is inferior to that of patients transplanted for chronic liver disease (67 % vs 88 % 1-year survival in Birmingham). For patients with FHF undergoing transplantation, pretransplant renal failure strongly predicts poor outcome with significantly greater consumption of resources. 相似文献
22.
大鼠肝细胞Ⅰ,Ⅲ型前胶原基因表达及PDGF的影响 总被引:3,自引:1,他引:2
目的观察大鼠肝细胞Ⅰ,Ⅲ型前胶原基因的表达及PDGF对其表达的影响.方法应用原位杂交技术检测分离培养的SD大鼠肝细胞(n=30)内Ⅰ,Ⅲ型前胶原基因的表达.同时观察10μg/L(n=30)和30μg/L(n=30)PDGF促进前胶原基因表达的作用.测定基因表达颗粒总面积占细胞总面积的百分比,并作比较分析.结果无论正常肝细胞或是在两种浓度的PDGF存在时,肝细胞内均可见到Ⅰ,Ⅲ型前胶原基因的表达.正常肝细胞Ⅰ,Ⅲ型前胶原基因表达面积的百分比(%)为77±19和75±21;加10μg/LPDGF后为115±19和112±10,而加30μg/L后为152±34及181±28,且在后者中表达明显增强(P<005及P<001).结论PDGF在转录水平上促进肝细胞胶原的合成. 相似文献
23.
应用原位杂交技术,观察了二乙基亚硝胺(DEN)诱发大鼠肝癌前病变组织中胎盘型谷胱甘肽S转移酶(GST-P)mRNA的表达。结果显示,GST-PmRNA主要在癌前病变肝组织中的变异灶及灶外卵圆形细胞内表达,且在变异灶间或和同一灶内阳性细胞间表达程度不尽一致,而正常肝、再生肝组织中未见其表达。提示在分子水平上变异灶细胞及卵圆型细胞可能成为实验性肝癌的癌前期细胞 相似文献
24.
生长激素、肝细胞生长因子和烟酰胺对人胎胰岛细胞的增殖作用 总被引:2,自引:0,他引:2
目的研究生长激素(GH),肝细胞生长因子(HGF)和烟酰胺(NIC)对体外培养的人胎胰岛细胞的增殖作用及其交互作用。方法采用La(2^7)正交设计法在体外培养的人胎胰岛细胞的各组中分别加入不同浓度及组合的GH,HGF和NIC,培养48h后,收集各孔细胞,DTZ染色,计数。结果GH,HGF和NIC均起主要作用,HGF和NIC的交互作用不可忽视,最佳的生长因子组合及适配浓度为GH(100ng/ml)HGF(25ng/ml)NIC(100mmol/L)。结论GH,HGF和NIC均能促进体外培养的胰岛细胞的增殖,且组合GH(100ng/ml)HGF(25ng/ml)NIC(100mmol/L)的作用最大。 相似文献
25.
Maarten E Tushuizen Mathijs C Bunck Petra J Pouwels Jan Hein T van Waesberghe Michaela Diamant Robert J Heine 《Liver international》2006,26(8):1015-1017
BACKGROUND: Fat accumulation in the liver or non-alcoholic fatty liver disease (NAFLD) is regarded as a key pathogenic factor and component of the metabolic syndrome. It was reported that administration of the incretin mimetic exenatide reversed hepatic steatosis in an obese mouse model. We had the opportunity to study the effect of additional exenatide administration on liver fat content in a patient with type 2 diabetes. CASE REPORT: A 59-year-old male with poorly controlled type 2 diabetes was treated with exenatide in addition to metformin monotherapy. Following 44 weeks of exenatide therapy, mean the liver fat measured by liver spectroscopy declined from 15.8% to 4.3%. This dramatic decrease in liver fat was accompanied by significant beneficial changes in several cardiovascular disease risk factors and improvement of all liver enzymes, in particular alanine aminotransferase, the most important marker of liver steatosis. CONCLUSION: This case report suggests that the incretin mimetic exenatide decreases hepatic fat accumulation and may play a role in the future treatment of NAFLD, and the associated insulin resistance and cardiovascular risk factors in an ever-growing high-risk population. 相似文献
26.
ALBERTO Q FARIAS LUCIANA L GONÇALVES EDUARDO LR CANÇADO ANTONIO C SEGURO SILVIA B CAMPOS CLARICE P ABRANTES-LEMOS FLAIR J CARRILHO 《Journal of gastroenterology and hepatology》2006,20(1):147-152
Background and Aims: Primary biliary cirrhosis (PBC) might be complicated by osteoporosis, whose etiology remains unknown but seems to be multifactorial. Prevalence rates of 30% to 60% for distal renal tubular acidosis (DRTA) have been reported in PBC patients, generally as incomplete DRTA. Although it is undisputed that a reduced bone mineral density (BMD) is the expected outcome among patients who have been suffering from longstanding chronic metabolic acidosis, it is unclear if incomplete DRTA is also associated with metabolic bone disease in PBC patients. The present study was undertaken to compare the BMD of PBC patients with and without DRTA.
Methods: The BMD of 23 PBC patients (11 with DRTA and 12 without), all with normal clearance of creatinine, was assessed by dual energy radiograph absorptiometry. The diagnosis of DRTA was made if the urine pH was above 5.4 in all samples after the oral acid overload, showing tubular inability to acidify urine in the presence of test-induced systemic metabolic acidosis.
Results: Densitometric signs of osteoporosis were found in 82% of DRTA cases and in 83% of patients without DRTA (difference not significant). There were no significant differences in BMD measurement, T and Z scores of patients with and without DRTA.
Conclusions: The present study could not support a correlation between the presence of DRTA and the bone loss observed in PBC patients. 相似文献
Methods: The BMD of 23 PBC patients (11 with DRTA and 12 without), all with normal clearance of creatinine, was assessed by dual energy radiograph absorptiometry. The diagnosis of DRTA was made if the urine pH was above 5.4 in all samples after the oral acid overload, showing tubular inability to acidify urine in the presence of test-induced systemic metabolic acidosis.
Results: Densitometric signs of osteoporosis were found in 82% of DRTA cases and in 83% of patients without DRTA (difference not significant). There were no significant differences in BMD measurement, T and Z scores of patients with and without DRTA.
Conclusions: The present study could not support a correlation between the presence of DRTA and the bone loss observed in PBC patients. 相似文献
27.
门脉高压症患者肝脏储备功能评估的临床研究 总被引:1,自引:0,他引:1
目的 :探讨肝硬化门脉高压症患者术前肝脏储备功能的评估方法。方法 :用L ogistic多元回归法分析了 80例门脉高压症断流患者术后出现肝功能不全的相关因素 ,从中筛选与肝功不全关系最密切的危险因子。结果 :排除手术操作本身的影响后 ,术后发生肝功不全影响最大的因素依次为 :肝性脑病 ( ENC)、血浆吲哚氰绿潴留试验 ( ICGR15)及门静脉充血指数 ( PCI)等 ,而术前的血清总胆红素 ( TBIL)、白蛋白 ( A)、A/G比值、总胆汁酸( TBA)、透明质酸 ( HA)、凝血酶原时间 ( PT)、门静脉内径 ( dp)、门静脉流速 ( Vp)及门静脉流量 ( Qp)等因素 ,在多元回归中所占比例不大。结论 :综合分析术前患者临床指标和肝功能实验室检查有助于评价肝硬化患者肝储备功能 ,预测手术风险及术后转归 相似文献
28.
影响肝外伤手术死亡的危险因素分析 总被引:3,自引:1,他引:2
目的分析影响肝外伤手术死亡的危险因素,探讨其临床意义。方法根据AAST和ISS标准,回顾性分析90例肝外伤手术病例,对影响手术死亡的危险因素进行单因素比较和Logistic回归分析。结果死亡15例,其中Ⅲ级2例、Ⅳ级4例、Ⅴ级9例,总体手术死亡率17%。Ⅳ~Ⅴ级肝外伤手术方式的单因素比较提示:清创性肝切除术的相对危险度是0.73;而规则性肝切除术、肝静脉或肝后下腔静脉修补术相对危险度分别是1.32、1.52。Logistic回归分析提示:ISS分会和术中失血量是影响手术死亡率的2个独立因素。结论ISS分值、术中失出血量和手术方式是影响肝外伤手术死亡的3个重要因素,娴熟的手术技能和合理的手术方式可以减少术中出血量和降低手术死亡率。 相似文献
29.
RAMÓN BATALLER VICENTE ARROYO PERE GINÈS 《Journal of gastroenterology and hepatology》1997,12(11):723-733
Ascites is one of the earliest and most common complications of patients with cirrhosis. A typical circulatory dysfunction characterized by arterial vasodilation, high cardiac output and stimulation of vasoactive systems is commonly present in these patients and is associated with a poor prognosis. The treatment of ascites has been based on the combination of a low-sodium diet and the administration of diuretics. The reintroduction of paracentesis and the recent introduction of the transjugular intrahepatic portosystemic shunt (TIPS) are the most relevant innovations in the treatment of ascites during the past two decades, although controlled trials in large series of patients are needed to delineate whether TIPS is a safe and useful treatment for these patients. 相似文献
30.