医用三氧对慢性重型肝炎患者肝肾综合征的预防作用

目的观察医用三氧对慢性重型肝炎患者肾素（PRA）、血管紧张素Ⅱ（AngⅡ）、醛固酮（ALD）、肾血流量和肾功能的影响,探讨医用三氧治疗重型肝炎对肝肾综合征的预防作用。方法将98例慢性重型肝炎患者随机分为医用三氧治疗组50例和对照组48例,治疗组为基础治疗加医用三氧治疗系统进行治疗,采用基本自血疗法,抽出患者静脉血100ml,然后与100ml（35μg/ml）的医用三氧混合后再回输到患者体内,隔天一次,疗程20d。对照组用基础治疗。用美国GELOGIQ-7彩色多普勒超声诊断仪作肾血流量的检测,找出肾动脉,电脑自动计算出平均血流速度及血流量,血流量V=π·（D/2）2·V（平均）·HIR（心率）。用放射免疫竞争抑制法检测PRA、AngⅡ、ALD。结果治疗后20d,治疗组PRA、AngⅡ、ALD较治前下降（P〈0.01）,也低于对照组治疗后20d（P〈0.01）,肾血流量较治前升高,也多于对照组治疗后20d（P〈0.01）,肾功能损害（肝肾综合征）的发生少于对照组（P〈0.01）。治疗组存活率高于对照组（P〈0.01）。结论基础治疗加医用三氧治疗慢性重型肝炎,能使PRA、AngⅡ、ALD下降,肾血流量增加,一定程度的防止肝肾综合征的发生,并能提高患者的存活率。

Effect of medical ozone therapy in the hepatorenal syndrome in patients with chronic severe hepatitis

Objective The study is aimed to observe the effects of medical ozone therapy on PRA,AngⅡ,ALD,renal blood flow and renal function in patients with severe chronic hepatitis and to explore the prevention of medical ozone therapy on hepatorenal syndrome.Methods 98 cases with chronic severe hepatitis were randomly divided into ozone therapy group（50 cases） and control group（48 cases）.The patients in the treatment group were treated with medical ozone plus the same basic medical treatments used for the control group.100 ml venous blood was drawn from each patient,and was mixed with 100 ml（35 μg/ml） medical ozone and then was returned the blood to the patient intravenously,once every other day for 20 days.Renal blood flow of the patients were determined by American GELOGIO-7 color Doppler ultrasonic examination.The levels of PRA,AngII and ALD were detected by RIA.Results The levels of PRA,AngⅡ,ALD in the treatment group were decreased significantly compared with those before treatment（P 0.01）,also lower than those of control group after treatment（P 0.01）.Renal blood flow was increased compared to before the treatment and also higher than that of the control group after the treatment（P 0.01）.Renal damage（hepatorenal syndrome） happened in the treatment group was less than that in the control group（P 0.01）.The survival rate in the treatment group was higher than that in the control group.Conclusion Combination therapy of medical ozone could decrease levels of PRA,AII and ALD significantly,increase renal blood flow,prevent hepatorenal syndrome and improve the survival rate of patients with chronic severe hepatitis.