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目的研究肝移植患者术前及术后血清肌酐(Cr)和尿素氮(BUN)的变化规律,探讨其临床价值。方法采用日立7180全自动生化分析仪检测88例肝移植患者术前1 d、术后1 d、3 d、7 d、30 d及术后1年血清Cr和BUN的动态变化。根据Cr和BUN的正常参考值,将患者分为术前正常组和术前异常组,比较2组患者术后变化规律。结果术前正常组术后Cr第1 d显著升高,第3 d开始逐渐下降,1个月后降低至治疗前的水平,但1年后较治疗前升高。术前异常组Cr从术后第3 d开始显著降低,术后7 d至30 d接近正常水平,术后1年略有升高,但仍显著低于治疗前水平。术前正常组BUN从术后第1 d开始,7 d内持续上升,30 d降低至治疗后1 d的水平,但1年后仍比治疗前高。术前异常组BUN从术后第3 d开始上升,术后7 d维持在较高水平,30 d恢复至治疗前的水平,1年后低于治疗前水平。结论术前不同肾功能状态的患者其Cr和BUN术后变化规律不同,可为肝移植后肾损伤评估及临床用药提供重要依据。
Objective To study the changes of serum creatinine (Cr) and blood urea nitrogen (BUN) in patients with liver transplantation before and after operation, and to explore its clinical value. Methods The dynamic changes of serum Cr and BUN in 88 patients with liver transplantation at 1 d, 1 d, 3 d, 7 d, 30 d and 1 year after operation were measured by Hitachi 7180 automatic biochemical analyzer. According to the normal reference values of Cr and BUN, the patients were divided into normal preoperative group and abnormal preoperative group. The changes of postoperative patients were compared. Results The level of Cr in the preoperative normal group was significantly increased on the 1st day and gradually decreased on the 3rd day, and decreased to the pre-treatment level after 1 month, but increased after 1 year. Preoperative abnormal Cr decreased significantly from the 3rd day after operation, approaching to the normal level from the 7th day to the 30th day after operation, slightly increased at 1 year after operation, but still significantly lower than the pre-treatment level. Preoperative normal group BUN from the first postoperative day, 7 d continued to rise, 30 d reduced to the level of 1 d after treatment, but after 1 year still higher than before treatment. Preoperative anomalous group BUN from the first postoperative 3 d began to rise, 7 d after surgery to maintain a high level, 30 d to return to pre-treatment levels, 1 year after the level was lower than before treatment. Conclusions The changes of Cr and BUN in patients with different renal function before operation are different, which may provide an important basis for the assessment of renal injury after liver transplantation and clinical medication.