Effect of medical ozone therapy in the hepatorenal syndrome in patients with chronic severe hepatitis
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摘要: 目的观察医用三氧对慢性重型肝炎患者肾素(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、肾血流量和肾功能的影响,探讨医用三氧治疗重型肝炎对肝肾综合征的预防作用。方法将98例慢性重型肝炎患者随机分为医用三氧治疗组50例和对照组48例,治疗组为基础治疗加医用三氧治疗系统进行治疗,采用基本自血疗法,抽出患者静脉血100ml,然后与100ml(35μg/ml)的医用三氧混合后再回输到患者体内,隔天一次,疗程20d。对照组用基础治疗。用美国GELOGIQ-7彩色多普勒超声诊断仪作肾血流量的检测,找出肾动脉,电脑自动计算出平均血流速度及血流量,血流量V=π·(D/2)2·V(平均)·HIR(心率)。用放射免疫竞争抑制法检测PRA、AngⅡ、ALD。结果治疗后20d,治疗组PRA、AngⅡ、ALD较治前下降(P<0.01),也低于对照组治疗后20d(P<0.01),肾血流量较治前升高,也多于对照组治疗后20d(P<0.01),肾功能损害(肝肾综合征)的发生少于对照组(P<0.01)。治疗组存活率高于对照组(P<0.01)。结论基础治疗加医用三氧治疗慢性重型肝炎,能...Abstract: Objective The study is aimed to observe the effects of medical ozone therapy on PRA, AngⅡ, ALD, renal blood flow and renal function in patients with severe chronic hepatitis and to explore the prevention of medical ozone therapy on hepatorenal syndrome.Methods 98 cases with chronic severe hepatitis were randomly divided into ozone therapy group (50 cases) and control group (48 cases) .The patients in the treatment group were treated with medical ozone plus the same basic medical treatments used for the control group.100 ml venous blood was drawn from each patient, and was mixed with 100 ml (35 μg/ml) medical ozone and then was returned the blood to the patient intravenously, once every other day for 20 days.Renal blood flow of the patients were determined by American GELOGIO-7 color Doppler ultrasonic examination.The levels of PRA, AngII and ALD were detected by RIA.Results The levels of PRA, AngⅡ, ALD in the treatment group were decreased significantly compared with those before treatment (P < 0.01) , also lower than those of control group after treatment (P < 0.01) .Renal blood flow was increased compared to before the treatment and also higher than that of the control group after the treatment (P < 0.01) .Renal damage (hepatorenal syndrome) happened in the treatment group was less than that in the control group (P < 0.01) .The survival rate in the treatment group was higher than that in the control group.Conclusion Combination therapy of medical ozone could decrease levels of PRA, AII and ALD significantly, increase renal blood flow, prevent hepatorenal syndrome and improve the survival rate of patients with chronic severe hepatitis.
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Key words:
- hepatitis /
- chronic /
- hepatorenal syndrome
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[1]Chen J, Han JH, Liu C, et al.Short-term entecavir therapy of chronic severe hepatitis B[J].Hepatobiliary Pancreat Dis Int, 2009, 8 (3) ∶261-266. [2] 周霞秋.肝衰竭的药物治疗[J].世界感染杂志, 2009, 9 (5) ∶281-285. [3]Matsui Y, Sugawara Y, Yamashiki N, et al.Living donor liver transplantation for fulminant hepatic failure[J].Hepatol Res, 2008, 38 (10) ∶987-996. [4]中华医学会.病毒性肝炎防治方案[J].中华肝脏病杂志, 2000, 8 (6) ∶324-329. [5]顾锡炳, 华忠, 王栋, 等.医用三氧与人工肝血浆置换治疗重型肝炎的对比研究[J].临床肝胆病杂志, 2008, 24 (2) ∶118-119. [6]王小丛, 孙琦, 于国良, 等.彩色多普勒对肝肾综合症及肝硬化失代偿期肾动脉血流动力学的研究[J].临床肝胆病杂志, 1996, 12 (4) ∶212-213. [7]梁春香, 由丽霞, 张青, 等.正常成人肾内动脉血流动力学的彩色多普勒研究[J].中国超声医学杂志, 1995, 11 (2) ∶103-106. [8]顾锡炳, 刘霞英, 徐月琴, 等.不限钠饮食与限钠饮食对肝硬化患者肾血流量及腹水消退的影响[J].中华消化杂志, 2008, 28 (1) ∶61-62. [9]曹红, 周敏, 周苗兰.三氧治疗慢性重型肝炎临床疗效观察[J].中国微循环, 2007, 11 (4) ∶269-270. [10]Wentworth P Jr, Mcdunn JE, Wentworth AD, et al.Evidence for antibody-catalyzed ozone formation in bacterial killing and inflammation[J].Science, 2002, 298 (13) ∶2195-2199. [11]Bocci V.Ozonization of blood for the therapy of viral diseases and immunodeficiencies.A hypothesis[J].Med Hypotheses, 1992, 39 (1) ∶30-34. [12] 郭亚兵, 周福元.医用臭氧治疗慢性乙型病毒性肝炎的初步认识[J].第一军医大学学报, 2005, 25 (增刊) ∶150-151. [13]熊号峰, 贾继东.肝衰竭合并肝肾综合症的研究进展[J].传染病信息, 2009, 22 (5) ∶269-272. [14]Rivolta R, Maggi A, Cazzaniga M, et al.Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites[J].Hepatology, 1998, 28 (5) ∶1235-1240. [15]Guevara M, Bru C, Gines P, et al.Increased cerebrovascular resistance in cirrhotic patients with ascites[J].Hepatology, 1998, 28 (1) ∶39-44. [16]刘建军, 智红.肝硬化腹水限钠治疗的弊端及其对策[J].新医学, 2003, 34 (2) ∶123. [17]Angeli P, Merkel C.Pathogenesis and management of hepatorenal syndrome in patients with cirrhosis[J].J Hepatol, 2008, 48 (suppl1) ∶s93-s103.
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