葛根素对急性胆源性胰腺炎肾损害内皮素机制的干预

目的 探讨急性胆源性胰腺炎肾损害的内皮素机制,并观察中药葛根素对其的改善作用. 方法 选择急性胆源性胰腺炎伴肾功能损害的患者32例,随机分为术后加用葛根素组(A组)和术后常规处理组(B组),各16例.另选同期急性胆源性胰腺炎不伴有肾功能损害的患者16例为C组,选无胆源性胰腺炎的普通肝胆疾病患者16例为D组.观察术前及术后1周各组血清内皮素及肾功能指标内生肌酐清除率的变化. 结果 术前A、B、C三组ET值均高于D组(P＜0.001),A、B两组内皮素值均高于C组(P＜0.001).术后1周,A组内皮素值低于B组(P=0.014),A组Ccr值高于B组(P=0.002). 结论 内皮素缩血管、引起肾血流下降的作用是急性胆源性胰腺炎时肾脏功能损害的重要机制.葛根素可以降低急性胆源性胰腺炎肾损害患者的血清内皮素含量,提高Ccr值对急性胆源性胰腺炎肾损害有一定的改善作用.

Effect of Puerarin on mechanism of endothelinin in biliary pancretitis with renal impairment

Objective To investigate the mechanism of endothelin (ET) in acute biliary pancretitis (ABP)with renal impairment, and examine the improvement of renal function by puerarin. Methods Thirty-two patients of ABP with renal impairment were selected and were randomly divided into group A and group B. Group A were given puerarin post-operatively, while group B were given common manegement postoperatively. Meanwhile, 16 ABP patients without renal impairment were selected as group C, and 16 nonABP patients who had common hepatic or biliary diseases were selected as group D. The levels of plsma ETand creatinine clearance rate(Ccr) of renal function in each group were observed pre-operation and 1 week post operation. Results In pre-operation the ET level in group A, B and C were higher than in group D(P ＜0.001), and the ET level in group A,B was higher than in group C(P＜0.001). Post operation after I week the ET level in group A was lower than in group B(P =0.014), while the Ccr level in group A was higher thanin group B ( P = 0.002). Conclusions The function of endothelin is an important mechanism in biliary pancretitis with renal impairment. Puerarin might reduce the ET level and increase the Ccr level in patients of ABP with renal impairment, improve the renal function of such patients.