1，6-二磷酸果糖对严重多发伤患者肝功能的保护作用_1.docVIP

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，使其释放白介素、肿瘤坏死因子等一系列细胞因子，后者通过Dis