S-腺苷蛋氨酸对梗阻性黄疸患者术后肝功能及营养状况影响的临床研究

目的：探讨S-腺苷蛋氨酸对梗阻性黄疸患者术后肝功能及营养状况的影响。方法：选择2010年8月至2012年7月我院肝胆病区收治的90例梗阻性黄疸患者为研究对象，随机分为S-腺苷蛋氨酸治疗组（48例）和对照组（42例），比较和分析静脉滴注S-腺苷蛋氨酸对梗阻性黄疸患者术后第5d、10d肝功能及营养指标的影响。结果：术后5d、10d，两组患者血总胆红素、直接胆红素、谷丙转氨酶、1．谷氨酰转肽酶、碱性磷酸酶水平较术前1d显著降低，且组内比较差异有统计学意义（P〈0．05），治疗组以上指标的下降程度较对照组更明显，差异有统计学意义（P〈0．05）。术后第10d，两组患者的血白蛋白、前白蛋白、转铁蛋白水平较术后第5d显著改善（P〈0．05）；术后第5、10d，两组组间血白蛋白、前白蛋白、转铁蛋白水平比较差异有统计学意义（P〈0．05）。结论：梗阻性黄疸患者术后应用腺苷蛋氨酸能促进黄疸消退，加快胆红素的排泄和肝功能的恢复，有利于患者营养状况的改善。

Observation on the Effect of S-adenosyl-L-methionine on Post-operative Live Function and Nutritional Status in Patients with Obstructive Jaundice

Objective： To study the effects of S-adenosylmethionine on post-operative liver function and nutritional status in patients with obstructive jaundice. Methods： 90 cases of obstructive jaundice admitted from August 2010 to July 2012 were selected and divided into the experimental group （with S-adenosylmethionine treatment） and control group randomly. The effect of intravenous infusion with S-adenosylmethionine on the liver function and nutrition indicators on 5 and 10 days after operation in patients with obstructive jaundice were compared and analyzed. Results： 5 and 10 days postoperation, the TBIL, DBIL, ALT, 7-GT and ALP levels were significantly reduced compared with those pre-operation （P〈0.05）, which were obviously lower in the experimental group compared with the control group （P〈0.05）. 10 days after postoperation, the levels of Alb, PA, TF of two groups both significantly improved compared with those after 5 days postoperation （P〈0.05）; which were significantly different between the two groups 5 and 10 days after postoperation （P〈0.05）. Conclusion： S-adenosylmethionine could promote the excretion of serum bilirubin, jaundice subsidise, recovery of liver function as well as the improvement of nutrition status of patients with obstructive jaundice.