The Hyperlipidemia Caused by Overuse of Glucocorticoid after Liver Transplantation and the Immune Adjustment Strategy.
The Hyperlipidemia Caused by Overuse of Glucocorticoid after Liver Transplantation and the Immune Adjustment Strategy.
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肝移植术后过度使用糖皮质激素所致高脂血症及免疫调节策略
DOI：
10.1155/2017/3149426
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发表时间：
2017
影响因子：
4.1
通讯作者：
Zheng S
中科院分区：
文献类型：
--
作者：
Meng X;Chen X;Wu L;Zheng S
糖皮质激素的过度使用可能导致肝移植术后的代谢紊乱，影响肝移植术后的远期疗效。本研究旨在探讨肝移植术后减少糖皮质激素使用的免疫调节策略。随访观察肝功能、脂代谢变化。本研究包括成人肝移植受者。根据激素使用情况分为3组：长期组（>3个月，n = 18）、短期组（<3个月，n = 20）和对照组（未使用激素，根治性肝切除，n = 22）。比较两组肝移植术后6个月肝功能（AST/ALT比值）和血脂的变化。肝功能指标AST/ALT比值长期组与短期组比较差异无显著性（P > 0.05）。短期组与长期组的急性排斥反应无明显差异，而长期组的TG、HDL、LDL和葡萄糖有明显变化（P < 0.05）。肝移植术后6个月，长期组代谢紊乱发生率明显高于长期组（P < 0.05）。应制定适当的免疫调节策略，避免糖皮质激素的过度使用。可降低肝移植术后高脂血症及其他代谢紊乱，而不增加急性排斥反应及肝功能损害。
The overuse of glucocorticoid may cause the metabolic disorders affecting the long term outcome of liver transplantation. This study aims to investigate the immune adjustment strategy by decreasing use of glucocorticoid after liver transplantation. The follow-up study was carried out on liver function and lipid metabolism. This study included adult recipients of liver transplantation. There were 3 groups according to their use of glucocorticoid: long term (>3 months, n = 18), short term (<3 months, n = 20), and control group (no use of glucocorticoid, radical hepatic resection, n = 22). The laboratory results of liver function (AST/ALT ratio) and serum lipid were compared 6 months after liver transplantation. AST/ALT ratio, the marker of liver function, showed no significant difference between long and short term group (P > 0.05). The acute rejection had no significant difference between short and long term groups, while TG, HDL, LDL, and glucose showed significant change in the long term group (P < 0.05). At 6 months after liver transplantation, the long term group showed higher metabolic disorders (P < 0.05). The proper immune adjustment strategy should be made to avoid overuse of glucocorticoid. It can decrease hyperlipidemia and other metabolic disorders after liver transplantation without increasing the acute rejection or liver function damage.