1，6-二磷酸果糖对严重多发伤患者肝功能的保护作用.DOCVIP

临床医学论文-1，6-二磷酸果糖对严重多发伤患者肝功能的保护作用 ??????????????? 作者：王志华，蔡金芳，王静恩 【摘要】? 目的 探讨1，6-二磷酸果糖（FDP）对严重多发伤患者肝功能保护作用的机制。方法 将44例多发伤患者随机分为FDP组（n=22）和对照组（n=22）。FDP组使用FDP 10 g/天静脉点滴，对照组给予门冬氨酸钾镁40 ml/天静脉点滴，其他治疗两组相同，疗程均为7天。于治疗前和治疗第8天测定血浆肿瘤坏死因子（TNF-α）和白细胞介素-6（IL-6）及血浆生化指标（AST、ALT、γ-GT）。结果 FDP组与对照组在治疗前TNF-α、IL-6、AST、ALT、γ-GT比较差异无统计学意义。两组血浆AST、ALT、γ-GT治疗后均较治疗前降低（P＜0.05），且FDP组较对照组下降明显（P＜0.05）。治疗后FDP组TNF-α、IL-6下降较对照组明显（P＜0.05）。结论 FDP对严重多发伤时肝功能损伤有良好保护功能，其机制与下调TNF-α、IL-6水平有关。 【关键词】? 多发伤；1，6-二磷酸果糖；肝脏功能；细胞因子 ???? Protective effect of fructose-1，6-diphosphate on liver function in severe multiple trauma patients ?????? ［Abstract］ Objective To study the protective effect of fructose-1，6-diphosphate（FDP） on liver function in severe multiple trauma patients.Methods Forty-four patients with severe multiple trauma were randomly divided into two groups.Twenty-two patients were given FDP in a dose 10 g/d through intravenous drip for 7 day as FDP group，and 22 patients were given potassium and magnesium aspartate 40 ml per day through intravenous drip for 7 days to serve as control group.The same treatment was given to both groups other than FDP.Plasma contents of tumor necrosis factor-α（TNF-α） ，interleukin-6（IL-6） and biochemistrial indexes were measured on admission and eight day in both groups.Results AST，ALT，γ-GT，TNF-α、IL-6 were not different both in FDP group and routine treatment group before treatment.After the treatment，plasma AST、ALT and γ-GT decreased in both groups，but the decreasing of all the indexes was more marked in FDP group（P＜0.05）.TNF-α、IL-6 levels reduced more significantly after treatment in FDP group than routine group （P＜0.01）.Conclusion FDP has beneficial effects in protecting liver function in patients with severe multiple trauma，which may be related to the reduction of serum level of TNF-α、IL-6. ??? ［Key words］ multiple trauma;fructose-1，6-diphosphate;liver function;cytokine ??? 严重多发伤后由于缺血、缺氧、感染等因素使氧自由基增多，抗氧化能力减弱，造成肝细胞损害。近来一系列研究表明严重多发伤后肠黏膜屏障受损导致肠道细菌和毒素移位，不仅直接损害肝细胞，而且激活肝巨噬细胞系统，