The Influence And Its Clinical Significance On The Bile Of Patients With Liver Transplantation Using Tauroursodeoxycholic Acid Capsules

Objective:Studying and analysis the patients' blood and the bile specimen who take liver transplantation. Analysis and evaluate the Clinical application effect and its effect on liver function and bile acid levels in patients and its clinical significance of the one who take the TUDCA Capsules.Methods:Choose the one who accept the liver transplantation from April,2011 to October,2015 in the Beijing Friendship Hospital to be the study object, there are 29 patients in the study. the 29 patients all take the conventional therapy after the liver transplantation,5 of them are take the T tube drainage. besides, the patients all give the UDCA capsules, postoperative 3 month(into group) using the TUDCA capsules for 6months.at the same time, the study get the patients' blood and the bile acid sample. the periods of getting the bile and blood samples are the day preoperative 3 month, preoperative 1 month, after operation, postoperative 1 month, postoperative 2 month, postoperative 3 month, postoperative 6 month, then use the laboratory inspection to analysis the blood specimens. Analysis and discuss the different time's level of TBIL,DBIL,AST,ALT,ALP,TBA and GGT; take the Gas chromatography mass spectrometry to analysis and discuss the bile specimens of the 5 patients, in the operation and the time 3 month after into group, to analysis the from of the acid bile by after and before using the UDCA and TUDCA capsules.Results:Analysis and discuss the different times of the blood specimens, the results are:(1)Analysis the TBIL and the DBIL, it have a descend between the preoperative 1month and the preoperative 3month,but the two are higher than the operation and the preoperative 1month level is higher than the preoperative 3month;after the operation, it have a decline in the TBIL and DBIL level, but there is no nostatistical significance in them, P >0.05.(2)comparing with the preoperative 3month,the ALT level in the preoperative 1month and operation time is higher and there is statistical significance, P<0.05;there are a decline after the operation periods, and the postoperative 1month has the most significant decline, the postoperative 3month and the postoperative 6month also increased but is lower than the operation level.(3)The ALP level increase in the preoperative months and it's decline in the postoperative months, and there is statistical significance in the operation period and the postoperative 6month,P<0.05.(4)The AST level increased in the preoperative 3 months, compared with operation period, the postoperative periods decline and there is statistical significance in the postoperative 1 month and the operation time, P<0.05.(5)The GGT level ascend in the preoperative 3month?preoperative 1month and operation time, it is statistical significance in the AST level of the postoperative 6 month and the operation, P<0.05.(6)TBA level get the highest level in operation, and it decline in postoperative, and there is statistical significance in the postoperative 2month and the operation time, P<0.05.Divided the patients in to two groups by the increase and decline of the figures, the ascending group and the declining group, there are 19 ascending patients and 5declining patients in the ALT?AST and TBA level; there are 12 ascending patients and 12 declining patients in the TBIL?DBIL?ALP and GGT level.(1)The TBIL level in ascending group ascend in the 3month after operation and decline in the postoperative 6month;the DBIL level ascend in the postoperative 1month and 2 month, but decline in the postoperative 3?6month;the declining group is undulate in the operation periods and there is nostatistical significance in postoperative 6month and operation time, P >0.05;The ALP and GGT level in the ascending group is decline in the postoperative 1month then ascended, but the ascending lever is lower than the operation level, the declining group is declined slowly, there is statistical significance in the postoperative 1 month in ALP level about the two groups, P<0.05.(2)It is decling obviously in the postoperative 1 month of the ALT level, and wave in the postoperative 2 and 3 month, the postoperative 6 month increased; the ascending group is ascended slowly, there is statistical significance in the postoperative 1 month in ALP level about the two groups, P<0.05.the ascending group ascend the AST level in the postoperative 3 and 6month,while the declining group is declined after the operation then increased, and it is less than the operation level, there is nostatistical significance in the TBA level in different periods, P >0.05. The CA/CDCA ratio has a decline in the first week after the operation, then increase in the first week to the first month after the operation; there is statistics significance in the first week of the CA/CDCA level, P<0.05.Conclusions : Comparing with the one who use the UDCA before the liver transplantation, the one who take the TUDCA capsules after liver transplantation have a better Clinical application effect. After the cure, the patients' AST and ALT level are controlled well and decline in a short time comparing with before the cure and using the UDCA capsules. so it explain that the TUDCA capsule can control the Liver function injure by kinds reasons and it's effects are very well than the UDCA capsule.The TUDCA and UDCA capsule also have a good influence on the TBA?DBIL and TBIL level, they all can decrease the complications such as Cholestasis and acute rejection and others after the liver transplantation. they can protect the liver function of the transplantation after operation and increase the sucess of operation; by the study, we know that the TUDCA capsule is better than the UDCA in the function of prctcet liver transplantation and it is worthy of clinical application.