肝肾及肝肾联合移植患者围手术期血浆AT活性检测及其临床意义.docVIP

【摘要】 目的 探讨肝、肾及肝肾联合移植患者围手术期及恢复期血浆AT活性测定的动态变化及其临床意义。方法 观察了176例各类终末期肝病患者、69例肾病患者、16例肝肾综合征患者在围手术期间血浆AT活性的动态变化。均于术前、术中、术后10d每天抽取静脉血，用发色底物法测定AT活性，并给予分析。结果 3组患者术中、术后早期血浆AT活性降低，恢复期AT的活性逐渐升高；肾脏移植组AT活性的恢复最快，与其它两组有显著差异性，而肝移植组与肝肾联合移植组AT的恢复无显著差异性。结论 AT活性的恢复是衡量移植物成功的较好指标之一；术后早期受者血液的抗凝作用减弱，处于危险的血栓形成高凝状态之中。 【关键词】 抗凝血酶； 肝脏移植； 肾脏移植； 肝肾联合移植 The Detection and Clinical Significance of Antithromnin Activity in Patients Follows Liver Transplantation ， Kidney Transplantation ，Combined LiverKidney Transplantation SONG Lijie，WANG Haiyan，Gao Jing*，Zhao yiwen （Department of Clinic laboratory,* Department of Hematology, General Hospital of Chinese People′s Armed Poice Forces; Beijing 100039, China） Abstract： Objective To explore the detection of antithrombin activity AT:A in patients during surgery period and the recovery period to forecast after liver transplantation ， kidney transplantation ，combined liverkidney transplantation.Methods observed alterations of ATA in 176 cases of endstage liver disease in liver transplant patients ,69 cases nehprotic syndrome，16 cases hepatorenal syndrome during surgery period . All the samples were obtained at preoperative stage and every day after operation and analyzed by the substrate linked with color assay in CA7000.Results In contrast to preoperative stage AT:A gradually decreased before reperfusion and gradually increased in recovery period, In comparison to the other groups there was significant difference in kidney transplantation . AT:A did not display significant changes between liver transplantation and combined liverkidney transplantation.Conclusion It is very important to measure AT:A in predicating the success of transplantation . anticoagulant functions were deceased at the early stage. It indicated the risk of potential thrombosis Key words： Antithrombin activity； Liver transplantation ； Kidney transplantation ； Combined liverkidney transplantation 原位肝移植、肾移植及肝肾联合移植,已经成为国内外临床治疗各种终末期肝病、肾病的最有效方法。肝移植术后血管并发症是目前肝移