肝移植术后危重患者血浆脂质过氧化物的变化及意义

目的　研究肝移植患者术后血浆中脂质过氧化物 (L PO)与术后病情变化的关系。方法　测定了18例肝移植患者术后 2 1d内血浆中 L PO的水平 ,分析其与预后的关系。结果　血浆 L PO在病情明显恶化前有所升高 ,尤其在死亡组患者持续升高 ,其升高的峰值明显高于存活患者 ,血浆 L PO峰值超过 10 μmol/L 的患者死亡几率 (5 /6 )高于血浆 L PO峰值低于 10 μmol/L 的患者 (1/12 ) ,两组病死率差异有显著性意义(P<0 .0 1) ,血浆 L PO日变化率超过 1.2 μmol· L- 1· d- 1的患者死亡几率 (4/5 )高于血浆 L PO日变化率低于 1.2 μmol· L- 1· d- 1的患者 (2 /13) ,两组病死率差异有显著性意义 (P<0 .0 1)。结论　术后检测血浆 L PO对正确判断患者病情危重程度有重要的临床价值 ,可作为常规检查。

Significance of Changes in plasma lipid peroxide levels in critical lyill patients after liver transplantation

OBJECTIVE: To investigate the relationship between plasma lipid peroxide (LPO) levels and prognosis in critically ill patients after liver transplantation. METHODS: Plasma LPO levels were measured in 18 patients within 21 days after liver transplantation, and their relations to the prognosis were analyzed. RESULTS: Plasma LPO levels were markedly elevated in patients before state of illness got severe, especially in those with fatal outcome. The peak LPO levels were much higher in non-survivors than in survivors, and mortality rate in patients whose plasma LPO exceeding 10 micromol/L (5/6 cases) was significantly higher than those under 10 micromol/L (1/12 cases, P<0.01). The mortality rate in patients with daily fluctuation range of plasma LPO levels over 1.2 micromol.L(-1).d(-1) was higher than those under 1.2 micromol.L(-1).d(-1), and the difference was significant between two groups (P<0.01). CONCLUSION: Measurement of plasma LPO level might be of clinical significance to properly judge the critically ill conditions, and it can be used as routine examination for patients after liver transplantation.