精氨酸对梗阻性黄疸病人肾脏损害的保护作用

目的 观察精氨酸对梗阻性黄疸（梗黄）病人肾功能的保护效应。方法34例梗黄病人,随机分为两组,分别在术前给予一般治疗（梗黄组）和精氨酸治疗（治疗组）,连续治疗7d,观察手术前后血ET（内毒素）及Ccr（内生肌酥清除率）变化,并与20例无黄疸的慢性胆囊炎、胆囊结石病人（对照组）比较。结果（1）入院时梗黄组与治疗组外周血ET及Ccr水平比较,差别无显著意义（P>0.05）,但上述两组ET均显著高于对照组（P<0.01）,Ccr显著低于对照组（P<0.01）;（2）梗黄组术后第1天血ET较术前升高（P<0.05）,Ccr更趋下降（P<0.05）,7d后随血ET水平下降,Ccr逐渐升高,第14天ET和Ccr两项指标接近正常水平;ET与Ccr呈显著负相关（P<0.05）;（3）治疗组用药后血ET水平下降,术后保持较低水平,而Ccr用药后升高,第7天ET、Ccr两项指标已接近正常水平。结论 术前使用精氨酸可显著降低梗黄病人内毒素血症,提高内生肌酥清除率,对肾功能具有良好的保护作用。

Protective effect of arginine to renal injury in patients with obstructive jaundice

Objective To observe the protective effect of arginine to renal injury in patients with obstructive jaundice. Methods 34 patients with OJ were randomly divided into general therapy group (OJ group) and arginine therapy group (Arg group). The level of plasma ET (endotoxin) and Ccr (endogenous creatinine clearance rate) were determined before and after operation, other 20 cases of chronic cholelithiasis without jaundice served as the control. Results (l)The plasma ET level increased significantly and Ccr level decreased markedly in both OJ group and Arg group than that of control group at 1st day of hospitalization ( P < 0.01). (2)InOJ group, the plasma ET level increased and Ccr decreased at 1st day post- operation. One week later, ET decreased and Ccr increased, both ET and Ccr parameters approached to normal at 14 days postoperation. ET was negatively correlated with Ccr significantly ( P < 0.05) . (3)In Arg group, the plasma ET levels decreased and Ccr increased significantly after arginine treatment. Both ET and Ccr parameters approached to normal at 7 days postoperation. Conclusions Arginine could decrease the endotoxin level and prevent renal damage in patients with OJ.