中文摘要：

目的 探讨腺苷蛋氨酸在肝移植术后对受体早期肝功能恢复的影响.方法 选择2010年1月至2012年10月,行肝癌肝移植治疗的57例患者,按其所接受的保肝治疗方案分为：A组23例,术后应用甘利欣、还原型谷胱甘肽和白蛋白等；B组34例,在A组治疗基础上再给予思美泰.回顾性分析并比较2组患者术前及术后1、4、7和14 d的AST、ALT、T-BIL、D-BIL、γ-GT、ALB和ALP含量.结果 57例患者术前均存在高胆红素血症、转氨酶升高、γ-GT和ALP浓度增高以及ALB下降等肝功能损害表现；移植后ld,2组患者与术前相比,ALP无变化,ALB显著下降（分别t=8.239,11.662,均P＜0.001）,其余指标（AST、ALT、T-BIL、D-BIL、γ-GT）均显著升高（分别t=10.493,7.089,6.584,15.134,5.164,10.344,5.289,13.034,3.389,4.366,均P＜0.01）.术后4d,除ALB上升外,其余各指标（AST、ALT、T-BIL、D-BIL、γ-GT、ALP）均显著下降,差异有统计学意义（分别t=2.536,2.736,2.218,3.318,4.804,2.892,均P＜0.05）.术后7d,2组患者各指标均继续有所改善,除y-GT外,2组比较差异有统计学意义（分别t=6.107,3.256,2.929,11.688,8.964,2.857,均P＜0.05）.术后14 d,B组患者T-BIL和D-BIL显著低于A组（分别t=4.413,8.493,P＜0.001）,其余指标比较差异无统计学意义（分别t=1.916,1.414,1.168,1.035,1.604,均P＞0.05）.结论 肝移植术后早期应用思美泰可迅速而显著地降低受体血浆AST、ALT、T-BIL、D-BIL、γ-GT和ALP含量,提高ALB含量,促进移植肝功能恢复,有利于患者的康复.

英文摘要：

Objective To study the effect of S-adenomethionine on early stage recovery of transplanted liver.Methods From January 2010 to October 2012,57 liver transplantation patients were divided into 2 groups beginning the first day：group A,23 patients were treated with routine liver-protecting therapy,including glycyrrhizin,glutathione,albumin; group B,34 patients treated with additional S-adenomethionine （Transmetil）.AST,ALT,T-BIL,D-BIL,γ-GT,ALB and ALP were compared between the two groups at pre-operation and post-operation day 1,day 4,day 7 and day 14.Results All patients suffered from preoperative hyperbilirubinemia,decreased ALB and elevated concentration of AST,ALT,γ-GT and ALP.On the first day after transplant,AST,ALT,T-BIL,D-BIL and γ-GT elevated and ALB decreased significantly in all cases compared with that before operation （respectively t =10.493,7.089,6.584,15.134,5.164,10.344,5.289,13.034,3.389,4.366,all P 〈 0.01）.On the contrary,the value of ALB was lower （respectively t =8.239,11.662,all P 〈 0.05）.On the fourth day posttransplant,ALB level was higher and that of other parameters were lower in group B when compared with group A （respectively t =2.536,2.736,2.218,3.318,4.804,2.892,all P 〈 O.05）.This tendency of liver function improvement continued till postoperative day 7 in all cases while the differences between the two groups remained significant （respectively t =6.107,3.256,2.929,11.688,8.964,2.857,all P 〈 0.05）except for γ-GT.On day 14,while T-BIL and D-BIL in group B were lower than that in group A （respectively t =4.413,8.493,all P 〈0.001）,differences of liver functions were not significant between the two groups （respectively t =1.916,1.414,1.168,1.035,1.604,all P 〉 0.05）.Conclusions Transmetil promotes the recovery of transplanted liver＇s function,elevates the concentrantion of ALB and reduces the concentration of AST,ALT,T-BIL,D-BIL,γ-GT and ALP at early stage after liver transplant.