[1]王昌明　 周孝思.δ胆红素在肝移植术后早期的变化规律及价值[J].中国微创外科杂志,2003,03(2):177-178.
　Wang Changming,ZhouXiaosi..Early profile and clinical significance of serum delta bilirubin after orthotopic liver transplantation[J].Chinese Journal of Minimally Invasive Surgery,2003,03(2):177-178.
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δ胆红素在肝移植术后早期的变化规律及价值()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
03
期数:
2003年2期
页码:
177-178
栏目:
基础研究
出版日期:
2003-02-28

文章信息/Info

Title:
Early profile and clinical significance of serum delta bilirubin after orthotopic liver transplantation
作者:
王昌明　 周孝思
北京大学第三医院普外科,北京,100083
Author(s):
Wang Changming; ZhouXiaosi.
Department ofGeneral Surgery,Peking UniversityThirdHospital,Beijing100083,China
关键词:
肝脏移植 δ胆红素 急性排斥反应
Keywords:
Liver transplantation　Delta bilirubin　Acute rejection
分类号:
R657.3;R446.11+2
文献标志码:
A
摘要:
目的探讨血清δ胆红素(δB)在肝移植术后早期的变化规律及临床意义. 方法 27例原位肝移植,按并发症有无分为:病情平顺组(10例),急性排斥反应组(8例),两组合并为痊愈组(18例),其余为围手术期死亡组(9例).比较各组病人术后每日血清δB的变化. 结果术后δB占总胆红素(Total bilirubin,TB)的百分比(δB%),病情平顺组病人逐渐升高,21天时达(37.5±11.2)%.急性排斥反应发生后,δB%由(26.4±9.8)%下降至(20.2±12.7)% (n=8,t=2.12,P＝0.07),TB、结合胆红素(Conjugated bilirubin,CB)峰值比排斥反应前基值显著升高(t=3.75,P=0.007;t=3.59,P=0.009).术后14天痊愈组δB%(n=18)明显高于死亡组(n=9),分别为(33.4±12.2)%和(22.0±10.0)%(t=2.42,P＝0.02). 结论术后14天时δB%与病人出院时转归有关.在排斥反应的诊断方面,血清TB和CB比δB%有更大优势.
Abstract:
Objective　To investigate the early variations and clinical value of serum delta bilirubin after orthotopic liver transplanta- tion.　Methods　Orthotopic liver transplantation was performed in 27 cases.Of them,10 cases were uneventful;8 patients suffered from acute rejection.According to the outcome,18 patients (including 10 uneventful cases and 8 cases with acute rejection) survived while other 9 died. Daily determination of serum delta bilirubin was examined in all patients.　Results　The changing patterns of serum delta bilirubin were dif- ferent between uneventful patients and those with acute rejection.For those uneventful patients,δB% tended to increase after operation.On the 21st day after transplantation,it reached(37·5±11·2)%.To the contrary,after acute rejection occurred,δB% decreased from basal level (26·4±9·8)% to(20·2±12·7)%(n=8,t=2·12,P=0·07).Serum concentration of total bilirubin (TB) and conjugated bilirubin (CB) significantly increased after acute rejection arose.The difference between peak and basal level ofTB and CBwas (150·3±113·2)μmol/L(n= 8)and(118·5±93·4)μmol/L(n=8)respectively(t=3·75,P=0·007;t=3·59,P=0·009).On the 14th day after operation,δB% in pa- tients with good outcome(n=18) significantly higher than that in patientswho died(n=9)(33·4%±12·2% vs 22·0%±10·0%,t=2·42, P=0·02).Conclusions　Two weeks after operations,δB% is correlative to the outcome of the patients.But as for the diagnosis of the acute rejection,δB% shows no advantages over serumTB or CB.

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更新日期/Last Update: 2014-06-10